UC-NI 


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THE  LIBRARY 

OF 

THE  UNIVERSITY 
OF  CALIFORNIA 

PRESENTED  BY 

PROF.  CHARLES  A.  KOFOID  AND 
MRS.  PRUDENCE  W.  KOFOID 


ZOONOMIA; 

OR, 

THE     LAWS 

Ofr 

ORGANIC       LIF 

IN  THREE   PARTS. 


By  ERASMUS  DARWIN,  M.D.RR.S* 

AUTHOR  OF  THE  BOTANIC  GARDEN,  PHYTOLOGIA,  &C. 


Principio  ccelum,  ac  terras,  campofque  liquentes, 
Lucentemque  globum  lunae,  titaniaque  aftra, 
Spiritus  intus  alit,  totatnque  infufa  per  artus 
Mens  agitat  molem*  et  nlagno  fe  corpora  mifcet. 

VIRG.  JEn. 

Er^rth,  on  whofe  lap  a  thoufand  nations  tread, 

And  Ocean,  brooding  his  prolific  bed, 

Night's  changeful  orb,  blue  pole,  and  filvery  zones. 

Where  other  worlds  encircle  other  funs, 

One  mind  inhabits,  one  diffufive  Soul 

Wields  the  large  limbs,  and  mingles  with  the  v 


COMPLETE     IS    TWO    VOLUMES. 


VOL.  II. 

•Second  American,  from  the  third  London  Edition,  corre&ed  by  the  Author. 


Printed  at  Bofton,  by  D.  CA&LISLE, 
FOR   THOMAS    AND   ANDREWS. 

d  at  their  Bookftore,  No.  45,  Newbury  Street;  by  I.  THOMAS,  Worcefter  ;  and 
tv  THOMAS  fe?  THOMAS,  Walpole,  N.  H.  —  Sold  alfo  by  T.  &f  J.  S\vo- 
Nevv  York  ;  WHITING,  I.,RAVEN\VORTH  &  WHITING,  Albany; 
O-  PENNIMAN    £?    Co.  Troy  ;    and   THOMAS, 
?   BUTLER,  Baltimore. 


Fi  ; 


""P 

z  o  o  N  o  M  i  A;'* 

Ll 

OR, 

THE   LAWS  OF  ORGANIC  LIFE. 
PART    II. 

CONTAINING 

A  CATALOGUE  OF  DISEASES, 

DISTRIBUTED   INTO 

NATURAL  CLASSES, 
0 

ACCORDING  TO  THEIR  PROXIMATE  CAUSES, 

WITH   THEIR  SUBSEQUENT 

ORDERS,  GENERA,  AND  SPECIES, 

AND  WITH   THEIR 
METHODS   OF   CURE. 


Haec,  ut  potero,  explicabo ;  nee  tamen,  quafi  Pythius  Apollo,  certa  ut  fint  et  fixa, 
qiue  dixero  ;  fed  ut  Homunculus  unus  e  multis  probabiliora  conjeelura  fequens. 

Cic.  Tusc.  DISP.  I.  i.  9. 


365943 


PREFACE. 


difeafes  originate  in  the  exuberance,  deficiency^ 
or  retrograde  a&ion,  of  the  faculties  of  the  fejiforiumt 
as  their  proximate  caiife  ;  and  confift  in  the  difordsred 
motions  of  the  fibres  of  the  bodya  as  the  praxiRWUs  e£ 
feel:  of  the  exertions  of  thofe  difordered  faculties, 

i 


The  fenforium  polfeffes  four  diftin£t  powers^  or 
ties,  which  are  occafionally  exerted^  and  produce  all  the 
motions  of  the  fibrous  parts  of  the  body  j  thcfe  are  the 
faculties  of  producing  fibrous  motions  in  ccmfequenee  of 
Irritation,  which  is  excited  by  external  bodies  $  in  con* 
fequence  of  fenfation,  which  is  excited  by  pleafure  or 
pain  ;  in  confequence  of  volition,  which  h  excited  by  de* 
fire  or  averfion  ;  and  in  confequence  of  aflbdatioHi 
which  is  excited  by  other  fibrous  motions,  We  ar« 
hence  fupplied  with  four  natural  clafles  of  difcafes  df« 
rived  from  their  proximate  caufes  j  which  we  ftall  term 
thofe  of  irritation,  thofe  of  fenfation,  thofe  of  voli1 
thofe  of  affociation, 


vi  PREFACE. 

In  the  fubfequent  clarification  of  difeafes  I  have  not 
adhered  to  the  methods  of  any  of  thofe  who  have  pre- 
ceded me  ;  the  principal  of  whom  are  the  great  names 
of  Sauvages  and  Cullen ;  but  have  neverthelefs  availed 
myfelf,  as  much  as  I  could ,  of  their  definitions  and  dif~ 
tinctions. 

The  effential  characteristic  of  a  difeafe  confifts  in  its 
proximate  caufe,  as  is  well  obferved  by  doctor  Cullen, 
in  his  Nofologia  Methodica,  T.  ii.  Prolegom.  p.  xxix. 
Shnilitudo  quidem  morborum  in  fimilimdine  caufse 
eorum  proximse,  qualifctinque  fit,  revera  confiftit.  I 
have  taken  the  proximate  caufe  for  the  claffic  character. 
The  characters  of  the  orders  are  taken  from  the  excefs, 
or.  deficiency,  or  retrograde  action,  or  other  properties, 
of  the  proximate  caufe.  The  genus  is  generally  derived 
from  the  proximate  effect.  And  the  fpecies  generally 
from  the  locality  of  the  difeafe  in  the  fyfhem. 

Many  fpecies  in  this  fyftem  are  termed  genera  in  the 
fy Items  of  other  writers  ;  and  the  fpecies  of  thofe  wri- 
ters, are,  in  confequence,  here  termed  varieties.  Thus, 
in  Dr.  Cullen's  Nofologia,  the  variola  or  fmall-pox  is 
termed  a  genus,  and  the  diftinct  and  confluent  kinds  are 
termed  fpecies.  But  as  the  infection  from  the  diftinct 
kind  frequently  produces  the  confluent  kind,  and  that  of 
the  confluent  kind  frequently  produces  the  diftinct ;  it 
would  feem  more  analogous  to  botanical  arrangement, 
which  thefe  nofologifts  profefs  to  imitate,  to  call  the  dif- 
tinct and  confluent  fmall-pox  varieties  than  fpecies. 
Becaufe  the  fpecies  of  plants  in  Botanical  fyftems  prop- 

agate 


PREFACE.  vii 

agate  others  fimilar  to  themfelves ;  which  does  not  uni- 
formly occur  in  fuch  vegetable  productions  as  are  term- 
ed  varieties. 

,  In  fome  other  genera  of  nofologifts  the  fpecies  have 
no  analogy  to  each  other,  either  in  refpect  to  their  prox- 
imate caufe,  or  to  their  proximate  effect,  though  they  may 
be  fomewhat  fimilar  in  lefs  effential  properties ;  thus 
the  thin  and  faline  difcharge  from  the  noftriis  on  going 
into  the  cold  air  of  a  frofty  morning,  which  is  owing  to 
the  deficient  action  of  the  abforbent  veflels  of  the  nof- 
trils, is  one  fpecies ;  and  the  vifcid  mucus  difcharged 
from  the  fecerning  veflels  of  the  fame  membrane,  when 
inflamed,  is  another  fpecies  of  the  fame  genus,  Catarrhus. 
Which  bear  no  analogy  either  in  refpect  to  their  imme- 
diate caufe,  or  to  their  immediate  effect. 

The  ufes  of  the  method  here  offered  to  the  public,  of 
clafling  difeafes  according  to  their  proximate  caufes,  are, 
firft,  more  diftinclly  to  underfland  their  nature  by  com- 
paring their  eflential  properties.  Secondly,  to  facilitate 
the  knowledge  of  the  methods  of  cure  ;  fince  in  natural 
claflification  of  difeafes  the  fpecies  of  each  genus,  and  in- 
deed the  genera  of  each  order,  a  few  perhaps  excepted, 
require  the  fame  general  medical  treatment.  And  laftly, 
to  difcover  the  nature  and  the  name  of  any  difeafe  previ- 
oufly  unknown  to  the  phyfician  ;  which  I  am  perfuaded 
will  be  more  readily  and  more  certainly  done  by  this 
natural  fyftem,  than  by  the  artificial  clarifications  alrea- 
dy publifhed. 


The 


till  1?RE¥ACE, 

The  common  names  of  difeafes  are  not  well  adapted 
to  any  kind  of  claffification,  and  leaf!  of  all  to  this,  from 
their  proximate  caufes.  Some  of  their  names  in  com* 
mon  language  are  taken  from  the  remote  caufe,  as 
worms,  (tone  of  the  bladder  ;  others  from  the  remote 
efFefi:,  as  diarrhoe^  falivation,  hydrocephalus  5  others 
from  fome  accidental  fymptom  of  the  difeafe,  as  tooth- 
ach>  head-ach,  heart-burn  ;  in  which  the  pain  is  only  a 
concomitant  circumftance  of  the  excefs  or  deficiency  of 
fibrous  aftionSj  and  not  the  caufe  of  them.  Others 
again  are  taken  from  the  deformity  occafioned  in  confe- 
ijuence  of  the  unnatural  fibrous  motions,  which  confti- 
tute  difeafes,  as  tumours,  eruptions,  extenuations ;  all 
thefe  therefore  improperly  give  names  to  difeafes  ;  and 
fome  difficulty  i«  thus  occafioned  to  the  reader  in  en* 
deavouring  to  difcover  to  what  clafs  fuch  diforders 
belong* 

Another  difSculty  attending  the  harries  of  difeafes  is:< 
that  one  name  frequently  includes  more  tlian  one  difeafe^ 
either  exiftlng  at  the  fame  time  or  in  fucceflion.  Thus 
the  pain  of  the  bowels  from  worms  is  caufed  by  the  in» 
creafed  action  of  the  membrane  from  the  flimulus  of 
thofe  animals  k>  but  the  convulfionSj  which  fometimes  fuc- 
^ceed  thefe  pains  in  children,  are  caufed  by  the  confequent 
Volition,  and  belong  to  another  clafs; 

To  difcover  under  what  clafs  any  difeafe  fliould  be  ar- 
ranged, we  mud  firft  invefligate  the  proximate  caufe  5 
thus  the  pain  of  the  tooth-ach  is  not  the  caufe  of  any 
difeafed  motions,  but  the  eiteft ;  the  tooth-ach  there- 
fore 


PREFACE.  ix 

fore  does  not  belong  to  the  clafs  of  Senfation.  As  the 
pain  is  caufed  by  increafed  or  decreafed  action  of  the 
membranes  of  the  tooth,  and  thefe  actions  are  owing  to 
the  increafe  or  decreafe  of  irritation,  the  difeafe  is  to  be 
placed  in  the  clafs  of  Irritation. 

To  difcover  the  order  it  muft  be  inquired,  whether 
the  pain  be  owing  to  increafed  or  defective  motion  of 
the  pained  membrane  ;  which  is  known  by  ihe  concom- 
itant heat  or  coldnefs  of  the  part.  In  tooth-ach  without 
inflammation  there  is  generally  a  coldnefs  attends  the 
cheek  in  its  vicinity  ;  as  may  be  perceived  by  the  hand 
of  the  patient  himfelf,  compared  with  the  oppofite  cheek. 
Hence  odontalgia  is  found  to  belong  to  the  order  of  de- 
creafed irritation.  The  genus  and  fpecies  muft  be  found 
by  infpecting  the  fynopfis  of  the  fecond  order  of  the  clafs 
of  Irritation.  See  Clafs  I.  2.  4.  12. 

This  may  be  further  elucidated  by  confldering  the 
natural  operation  of  parturition  ;  the  pain  is  occaiioned 
by  the  increafed  action  or  diftention  of  the  veffels  of  the 
uterus,  in  confequence  of  the  ftimulus  of  the  fetus  ;  and 
is  therefore  caufed  by  increafed  irritation  ;  but  the  ac- 
tions of  the  abdominal  mufcles  in  its  exclufion  are  cauf- 
ed by  the  pain,  and  belong  to  the  clafs  of  increafed  fen- 
fation.  See  Clafs  II.  i.  i.  12.  Hence  the  difficulty  of 
determining,  under  what  clafs  of  difeafes  parturition 
mould  be  arranged,  confifts  in  there  being  two  kinds  of 
difeafed  actions  comprehended  under  one  word ;  which 
have  each  their  different  proximate  caufe, 

VOL.  II.  b  In 


x  PREFACE. 

In  Sea.  XXXIX.  8.  4.  and  in  Clafs  II.  i.  i.  i.  we 
have  endeavoured  to  give  names  to  four  links  of  animal 
caufation,  which  conveniently  apply  to  the  clafTification 
of  difeafes  ;  thus  in  common  nictitation,  or  winking  with 
the  eyes  without  our  attention  to  it,  the  increafed  irrita- 
tion is  the  proximate  caufe ;  the  ftimulus  of  the  air  on 
the  dry  cornea  is  the  remote  caufe  ;  the  clofmg  of  the 
eyelid  is  the  proximate  effect ;  and  the  diffufion  of  tears 
over  the  eyeball  is  the  remote  effect.  In  fome  cafes  two 
more  links  of  caufation  may  be  introduced  ;  one  of 
them  may  be  termed  the  preremote  caufe  ;  as  the  warmth 
or  motion  of  the  atmofphere,  which  caufes  greater 
exhalation  from  the  cornea.  And  the  other  thepoft-re- 
mote  effect;;  as  the  renewed  pellucidity  of  the  cornea; 
and  thus  fix  links  of  caufation  may  be  expreffed  in 
words. 

But  if  amid  thefe  remote  links  of  animal  caufation  any 
of  the  four  powers  or  faculties  of  the  fenforium  be  intro- 
duced, the  reafoning  is  not  juft  according  to  the  method 
here  propofed  ;  for  thefe  powers  of  the  fenforium  are 
always  the  proximate  caufes  of  the  contractions  of  an- 
imal  fibres  ;  and  therefore  in  true  language  cannot  be 
termed  their  remote  caufes.  From  this  criterion  it 
may  always  be  determined,  whether  more  difeafes  than 
one  are  comprehended  under  one  name  ;  a  circumftance 
which  has  much  impeded  the  inveftigation  of  the  caufes, 
and  cures  of  difeafes. 

Thus  the  term  fever,  is  generally  given  to  a  collection 
of  morbid  fymptoms  ;  which  areiadeed  fo  many  diftinct 

difeafes, 


PREFACE.  xi 

difeafes,  that  fometimes  appear  together,  and  fometimes 
feparately  ;  hence  it  has  no  determinate  meaning,  except 
it  fignifies  fimply  a  quick  pulfe,  which  continues  for 
fome  hours  j  in  which  fenfe  it  is  here  ufed. 

In  naming  difeafes  I  have  endeavoured  to  avoid  the 
affectation  of  making  new  compound  Greek  words, 
where  others  equally  expreffive  could  be  procured  :  as 
a  mort  periphrafis  is  eafier  to  be  underftood,  and  lefs 
burdenfome  to  the  memory. 

In  the  Methodus  Medendi,  which  is  marked  by  M.  M. 
at  the  end  of  many  of  the  fpecies  of  difeafes,  the 
words  incitantia,  forbentia,  torpentia,  &c.  refer  to  the 
articles  of  the  Materia  Medica,  explaining  the  operations 
of  medicines. 

The  remote  caufes  of  many  difeafes,  their  periods, 
and  many  circumitances  concerning  them,  are  treated 
of  in  the  preceding  volume ;  the  defcriptions  of  many 
of  them,  which  I  have  omitted  for  the  fake  of  brevity, 
may  be  feen  in  the  Nofologia  Methodica  of  Sauvages, 
and  in  the  Synopfis  Nofologiae  of  Dr.  Cullen,  and  in  the 
authors  to  which  they  refer. 

In  this  arduous  undertaking  the  author  folicits  the 
candour  of  the  critical  reader  ;  as  he  cannot  but  forefec, 
that  many  errors  will  be  difcovered,  many  additional  fpe- 
cies will  require  to  be  inferted  ;  and  others  to  be  tranf- 
planted  or  erafed.  If  he  could  expend  another  forty 
years  in  the  practice  of  medicine,  he  makes  no  doubt,  but 

that 


six  PREFACE. 

that  he  could  bring  this  work  nearer  perfection,  and 
thence  render  it  more  worthy  the  attention  of  philofo- 
phers. As  it  is,  he  is  induced  to  hope,  that  fome  ad- 
vantages will  be  derived  from  it  to  the  fcience  of  medi- 
cine, and  confequent  utility  to  the  public,  and  leaves  the 
completion  of  his  plan  to  the  induftry  of  future  genera- 
tions. 

DERBY,  Jan.  i,  1796. 


ZOONOMIA  ; 


Z  O  O  N  O       I  A. 


PART     II. 


CLASSES    OF    DISEASES. 


I.  DISEASES  OF  IRRITATION. 
II.  DISEASES  OF  SENSATION. 

III.  DISEASES  OF  VOLITION. 

IV.  DISEASES  OF  ASSOCIATION. 


The  Orders  and  Genera  of  the  Firft  Clafs  of  Dlfeafes, 
CLASS    I. 

DISEASES    OF    IRRITATION, 

ORDO   I. 

Increofed  Irritation. 
GENERA. 

1 .  With  increafed  actions  of  the  fanguiferous  fyflem. 

2.  With  increafed  actions  of  the  fecerning  fyftem. 

3.  With  increafed  actions  of  the  abforbent  fyftem. 

4.  With  increafed  actions  of  other  cavities  and  membranes, 

5.  With  increafed  actions  of  the  organs  of  fenfe. 

ORDO  II. 

Decreafed  Irritation. 
GENERA. 

1 .  With  decreafed  actions  of  the  fanguiferous  fyftem. 

2.  With  decreafed  actions  of  the  fecerning  fyftem. 

3.  With  decreafed  actions  of  the  abforbent  fyftem. 
VOL.  II.  B  . 


DISEASES  CLASS  I.  i.  2, 

4.  With  decreafed  a&ions  of  other  cavities  and  membranes- 

5.  With  decreafecl  actions  of  the  organs  of  fenfe. 

ORDO  III. 

Retrograde  Irritative  Motions, 
GENERA. 

1.  Of  the  alimentary  canal. 

2.  Of  the  abforbent  fyftenru 

3.  Of  the  fanguiferous  fyftem. 


The  Orders,  Genera,  and  Species,  of  the  Firft  Clafs  ofDif- 

eafes. 

CLASS     I. 

DISEASES   OF    IRRITATION. 

ORDO  I. 

Increafed  Irritation. 

GENUS  I. 

With  increafed  Actions  of  the  Sanguiferous  Syjlem. 
SPECIES. 

1 .  Febris  irritativa.  Irritative  fever. 

2.  Ebrietas.  Drunkennefs. 

3.  Hamorrhagia  arterhfct.  Arterial  Haemorrhage. 

4.  Hamoptoe  arteriofa.  Spitting  of  arterial  blood. 

5.  Hamorrhagia  narium.  Bleeding  from  the  note. 

GENUS  II. 

With  increafed  Actions  of  the  Secerning  Syjlem. 
SPECIES. 

j.   Calor  febrills .  Febrile  heat. 

2.  Ruborfebrilis.  Febrile  rednefs. 

3.  Sudor  Caliduf.  Warm  fweat. 
Sudorfebrilis.  Sweat  in  fevers. 

a  labore. from  exercife. 

ab  igne.  from  fire. 

~ a  medicamentis.  from  medicines. 

4.  Ui'ina  ulterior  cokrata.  Copious  coloured  urine. 

5.  Diarrhoea 


CLASS  I.  i.  3.  OF  IRRITATION. 

5.  Dirrbcea  calida.  Warm  diarrhcsa. 

. febrilis.  Diarrhoea  from  fever. 

. crapulofa.  • from  indigeition. 

infantum. of  infants. 

6.  Salivatio  calida.  Warm  falivation. 

7.  Catarrhus  calidus.  —  catarrh. 

8.  Expecioratio  calida.  expectoration. 

9.  Exfudatio  pone  aures.  Difcharge  behind  the  ears. 
jo.   Gonorrhoea  calida.  Warm  gonorrhoea. 

1 1 .  Fluor  albus  calldus.  fluor  albus. 

12.  Hamorrhois  alba.  White  piles. 

13.  Serum  e  veficatorio.  Difcharge  from  a  blifter. 

14.  Perfpiratio  foetida.  Fetid  perfpiration. 

15.  Crines  novi.  New  hairs. 

GENUS  III, 

With  itureafed  Actions  of  the  Abforbent  Syjlem. 
SPECIES. 

1 .  Lingua  arida.  Dry  tongue. 

2.  Fauces  arid<z.  Dry  throat. 

3.  Nares  aridi.  Dry  noftrils. 

4.  Expefioratio  folida.  Solid  expectoration. 

5.  Conflipatio  a/vi.  Coltivenefs. 

6.  Cutis  arida.  Dry  (kin. 

7.  Urina  parcior  colorata.  Diminifhed  coloured  urine* 

8.  Calculus felleus  et  icJerus.  Gall-ftone  and  jaundice. 

9.  • rents.  Stone  of  the  kidney. 

jo.  •  <vefic£.  Stone  of  the  bladder. 

11.   ,  arthriticus.  Gout-ftone. 

12.  Rheumatifnius  chronicus.          Chronic  rheumatifm. 

13.  Cicatrix  vulnerum.  Healing  of  ulcers. 
J4.  Cornea  obfufcatio.                    Scar  on  the  cornea. 

GENUS  IV. 

With  increafed  A5lions  of  other  Cavities  and  Membranes. 
SPECIES. 

1.  Niftitatio  irritativa.  Irritative  nictitation. 

2.  Deglutitio  irritativa.  Irritative  deglutition. 

3.  Refpiratio  et  tuffis.  Refpiration  and  cough. 

4.  Exclufio  bills.  Exclufion  of  the  bile. 

5.  Dentitio.  Toothing. 

6.  Priapifmus.  Priapifm. 

7.  Diftcnfio  mammularum.  Diflention  of  the  nipples. 

8.  Defcenfa-. 


#  DISEASES  CLASS  I.  j.  5, 

.8.  Defcenfus  uttri.  Defcent  of  the  uterus. 

9.  Prolapfus  ani.  Defcent  of  the  rectum* 

10.  Lumlricus*  Round  worm. 

11.  Tania.  Tape- worm. 

12.  Afcarides.  Thread-worms. 

13.  Dracunculus,  Guinea- worm. 

14.  Morpiones.  Crab-lice. 

15.  fediculi.  Lice. 


GENUS  V. 

With  increased 

AElions  of  the  Organs  ofSenfe* 

SPEqES. 

I.   Vifus  acrior. 

Acuter  fight. 

2.   Audit  us  acrior. 

•  hearing. 

3.   Qlfaflus  acrior. 

.  fmell. 

4.    Guflus  acrior. 

tafte. 

5.   Tact  us  acrior. 

—  touch. 

6.   Senfus  colons  acrior. 

•  —  -»         fenfe  of  heat. 

-  extenfanis  acrior,           fenfe  of  extenfioin, 

8.   Titillatio. 

Tickling. 

9.  Pruritus. 

Itching. 

lo.   Dolor  urens. 

Smarting. 

II.   Confternatio. 

Surprife. 

ORDO  II. 

jDecreafed  Irritation. 

GENUS  I. 
-With  decreased  Actions  of  the  Sanguiferous  Syflem, 

SPECIES. 
'I.  Felris  inirritativa.  Jnirritative fever. 

2.  Par  efts  inirritativa.  • debility. 

3.  Somnus  interrupt™.  Interrupted  fleep. 

4.  Syncope.  Fainting. 

5.  Hamorrhagia  venofa.  Venous  haemorrhage. 

6.  Hamorrhois  cruenta.  Bleeding  piles. 

7.  Hamorrhagia  renum. —    from  the  kidneys. 

8. hepatis.  Bleeding  from  the  liver. 

9.  Hzmoptoe  venofa.  Spitting  of  venous  blood. 

10.  Palpitatio  ccrdis.  Palpitation  of  the  heart. 

11.  Mencrrhagia.  Exuberant  menftruation. 
\  2.   Dyfmenorrhagia.  Deficient  menftruation. 
33.  LocJjia  nimia.  Too  great  lochia. 

j^.  Abortio  fpontanea.  Spontaneous  abortion. 

jc.  Scorbvtus* 


CLASS  I.  2.  2. 


OF  IRRITATION. 


I£.  Scorbutus* 

j6.  Vibicet. 

17.  Petechia. 

1 8.  Aneurifma. 

19.  Varix* 


Scurvy. 

Extravafations  of  bloodc 
Purple  fpots. 
Aneurifrn. 
Swelling  of  veins. 


GENUS  II. 

With  decreafed  Actions  of  the  Secerning  Syjlent* 
SPECIES. 


1.  Frigits  febrile. 
chronicum. 

2.  Pallor  fugitivits. 
permanens. 

3.  Pus  parents. 
/(.   Jll  ucus  pa  rcior* 

5 .  Urifia  par  dor  pailida. 

6.  Torpor  hepaticus. 

7.  Torpor  p  finer  eatis. 

8.  Torpor  renis. 

9.  PunElz  muccfe  vultus. 
lo.  Macula  cutisfuhx. 

I  f .   Candies, 

12.  Callus. 

13.  Cataracla. 

14.  Innutritio  offiitm. 
J5«  Rachitis. 

1 6.   5/>/w^  diftortio. 

1 J.   Claiidicqtio  cox  aria. 

1 8.  S/>/fl0  protuberans. 

19.  S/>/'flrt  bifida. 

20.  DefecJus  palati. 


Coldnefs  in  fevers. 
-  permanent. 
Palenefs  fugitive. 
,  --  permanent. 
Diminifhed  pus. 
Diminifhed  mucus. 
Pale  diminifhed  urine. 
Torpor  -of  the  liver. 
Torpor  of  the  pancreas. 
Torpor  of  the  kidney. 
Mucous  fpots  on  the  face* 
Tawny  blots  on  the  fkin» 
Grey  hairs. 
Callus. 


Innutrition  of  the  bones. 

Rickets. 

Diftortion  of  the  fpine. 

Lamenefs  of  the  hip. 

Protuberant  fpine. 

Divided  fpine. 

Defccl:  of  the  palate. 


GENUS  III. 

With  decreafed  Actions  of  the  Abforbent  Svftem, 
SPECIES. 

Mucus  fauciamfrigidus. 
Sudor  frigidus . 
Gatarrhusfrigidus. 
Expeftoratio  frigicla. 
Urina  uberior  pallida. 
Diarrhcea  frigid  a. 

7.  Fluor  albus  frigidus, 

8 .  Gonorrhoea  frigidn. 


Cold  mucus  from  the  throaty 

fweat. 

catarrh. 

expectoration. 


Copious  pale  urine. 
Cold  diarrhoea. 
— —  Fluor  albus. 
gonorrhoea. 


9.   Hepaiis 


DISEASES 


CLASS  I.  2*  4, 


9- 

"/j  tumor. 

10. 

Cbhrofis. 

Ji. 

Hydrocele. 

12. 

Hydrcct'pkahts  interims. 

J3- 

JJjclUs. 

14. 

Hydrotborax. 

*5- 

Hy  drops  ovarii. 

16. 

Analnrca  pulmcmrm. 

*7- 

Qbefiifis'* 

1  8. 

Splenis  turner. 

19. 

Get  ut  tumor  all  us. 

20. 

Broncbccele. 

21. 

Scrofula* 

22. 

Scirrh'tf. 

23. 

refli. 

24. 

,    t/f*&tJuf*& 

'  cefoph 

Laaeornm  imrritabilita, 

2  7  .   Z-  ymphaiicoru  m  inlri'iia  bill- 


Swelling  of  the  liver. 

.Green  ficknefs. 

Dropiy  of  the  vagina  teftis. 

• of  the  brain. 

of  the  belly. 

of  the  cheft. 

of  the  ovary. 

• —  of  the  lungs. 

Corpulency. 

Swelling  of  the  fpleen. 

White  {welling  of  the  knee. 

Swelled  throat. 

King's  evil. 

Scirrhus. 

of  the  return. 

of  the  urethra. 

• of  the  throat. 

Inirritability  of  the  lafteals. 
Inirritability  of  the  lymphatics, 


tas. 


GENUS  IV. 

Wtih  decreajcd  Actions  of  other  Cavities  and  Membranes. 
SPECIES. 


I. 


Sifts  calida. 
—  '  --  frigula. 
Efuries. 
Nanfeajicca. 
JR  grit  udo  vetttricuK. 
Cardialgia* 
6.  Arthritis  ventriculi. 
"j.    Colicajtatu'etita. 
8.    Colica  faturnina. 
^.   Tympanitis. 
lo.   Hypochondriajis. 
1  1  .    Cefihalaa  idiopathica. 
I  2-   Hcmicrania  idiopathica. 
_  •.   tydontalgia. 

'pa. 

1  4  .  Pleurodyne  chronica. 
1  5.   Sciatica  frigida. 

.  L  n  in  oago  frrnda. 
17.    .Hv/leriilgia  frigida* 
•I  8.   1  *  ^clc.lgia  frigidn. 


Third  warm. 

cold. 

Hunger. 

Dry  naufea. 

Sicknefs  of  ftomach, 

Keart-burn. 

Gout  of  the  ftomach. 

Flatulent  colic. 

Colic  from  lead. 

Tympany. 

Hypochondriac  ifm. 

Idiopathic  head-ach. 

Idiopathic  hemicrania. 

Tooth -ach. 

Ear-ach. 

Chronical  pain  of  the  fide/ 

Cold  fciatica. 

lumbago. 

pain  of  the  uterus. 

pain  of  the  reclium. 

19 


CLASS  I.  3.  i.  OF  IRRITATION.  7 

19.   Vefic£  fdle<z   inirritabilitas     Inirritability  of  the  gall-blacIJer 
etifterus.  and  jaundice. 

GENUS  V. 

With  decreafed  AH  ions  of  the  Organs  ofSenfe. 
SPECIES. 

1.  Stultitia  inirritabilis.  Folly  from  irritability. 

2.  Vifus  imminutiis.  Impaired  vifion. 

3.  Mufce  volitantes.  Dark  moving  fpecks. 

4.  Strabifmus.  Squinting. 

5.  Amaurcfis.  Palfy  of  the  optic  nerve, 

6.  Auditus  imminutiis.  Impaired  hearing. 

7.  Olfatlus  imminutus. fmell. 

8.  Gujlus  immmutus.  — tafte. 

9.  Taclus  imminutus.  touch. 

lo.  Stupor.  Stupor. 

ORDO  III. 

Retrograde  Irritative  Motions. 

GENUS  I. 

Of  the  Alimentary  Canal. 
SPECIES. 

1.  Ruminatio.  Chewing  the  cud. 

2.  Ruflus.  Eru&ation. 

3.  Apepfia.  Indigeftion,  water-qualm. 

4.  Vomitus.  Vomiting. 

5.  Cholera.  Cholera. 

6.  Ileus.  Iliac  paflion. 

7.  Globus  hyjiericiis.  Hyfteric  ftrangulation.      % 

8.  Vomen di  conamen  inane.  Vain  efforts  to  vomit. 

9.  Borborigmus.  Gurgling  of  the  bowels. 

10.  Hyfteria.  Hyfteric  difeafe. 

1 1 .  Hydrophobia.  Dread  of  water. 

GENUS  II. 

Of  the  Abforbent  Syftem. 

SPECIES. 

1.  Catarrhus  lymphaticus.  Lymphatic  catarrh. 

2.  Sa/ivatio  lympbatica.  Lymphatic  falivation. 

3.  Naufea  humida.  Moift  naufea. 

4.  Diarrhea  lympbatica.  Lymphatic  flux. 

5.  Diarrhoea  chylifera.  Flux  of  chyle. 

6.  Diabetes. 


i  DISEASES,  &c,  CLASS  I.  3. 31 

6.  Diabetes.  Diabetes. 

7.  Sudor  lymphaticus.  Lymphatic  fweat. 
8-  Sudor  afthmaticus.  Afthmatic  fweat. 

9.  Tranjlatio  puris.  Tranflation  of  matter. 

j0. laftis.  of  milk, 

II.  .          — —  urina. of  urine. 

GENUS  III. 

Of  the  Sanjrttiferouf  Syfteni* 
SPECIES.   ' 

1.  Capillarium  motus  refrogref-  Retrograde  motion  of  the  ca~ 
fus.  pillaries. 

2.  Palpitatio  cordis.  Palpitation  of  the  heart. 

3.  Anhelatio  fpflfmodica*  Spafmodic  panting. 


CLASS 


CLASS  I.  i,  r.  DISEASES,  £c.  9 

CLASS    I. 

DISEASES    OF    IRRITATION. 

ORDO    I. 

Increafed  Irritation. 

GENUS  I. 
With  increafed  aclions  of  the  Sanguifirous  Syjlem, 

THE  irritability  of  the  whole,  or  of  part,  of  our  fyftem  is  per- 
petually changing  ;  thefe  viciffitudes  of  irritability  and  of  inir- 
ritability  are  believed  to  depend  on  the  accumulation  or  exhauf- 
tion  of  the  fenforial  power,  as  their  proximate  caufe  ;  and  on  the. 
difference  of  the  prefent  ftimulus,  and  of  that  which  we  had 
previoufly  been  accuftomed  to,  as  their  remote  caufe.  Thus  a 
fmaller  degree  of  heat  produces  pain  and  inflammation  in  our 
hands,  after  they  have  been  for  a  time  immerfed  in  fnow ; 
which  is  owing  to  the  accumulation  of  fenforial  power  in  the 
moving  fibres  of  the  cutaneous  vefiels  during  their  previous  qui- 
efcftice,  when  they  were  benumbed  with  cold.  And  we  feel 
ourfelves  cold  in  the  ufual  temperature  of  the  atmofphere  on 
coming  out  of  a  warm  room  ;  which  is  owing  to  the  exhauftion 
of  fenforial  power  in  the  moving  fibres  of  the  veffels  of  the  (kin. 
by  their  previous  increafed  activity,  into  which  they  were  exci- 
ted by  unufual  heat. 

Hence  the  cold  fits  of  fever  are  the  occafion  of  the  fucceedmg 
hot  ones  ;  and  the  hot  fits  contribute  to  occafion  in  their  turn 
the  fucceeding  cold  ones.  And  though  the  increafe  of  ftimulus, 
as  of  heat,  exercife,  or  diftention,  will  produce  an  increafed  ac- 
tion of  the  ftimulated  fibres ;  in  the  fame  manner  as  it  is  pro- 
duced by  the  increafed  irritability  which  was  occafioned  by  a 
previous  defect  of  ftimulus  ;  yet  as  the  excelles  of  irritation  from 
the  ftimulus  of  external  things  are  more  eafily  avoided  than  the 
deficiencies  of  it ;  the  difeafes  of  this  country,  except  thofe  which 
are  the  confequences  of  drunkennefs,  or  of  immoderate  exercife, 
more  frequently  begin  with  torpor  than  with  orgafm  j  that  is* 
with  inactivity  of  fome  parts,  or  of  the  whole  of  the  fyftem,  and 
confequent  coldnefs,  than  with  increafed  -activity,  and  confe- 
quent  heat. 

If  the  hot  fit  be  the  confequence  of  the  cold  one,  it  may  be 
aflced  if  they  are  proportionate  to  each  other  :  it  ft  probable  that 

VOL.  II.  C  the* 


io  .  DISEASES        ^        CLASS  I.  i.  i.  *„ 

they  are,  where  no  part  is  deftroyed  by  the  cold  fit,  as  in  morti- 
fication or  death.  But  we  have  no  meafure  to  diftinguifli  this, 
except  the  time  of  their  duration  •,  whereas  the  extent  of  the 
torpor  over  a  greater  or  lefs  part  of  the  fyftem,  which  occafions 
the  cold  fit ;  or  of  the  exertion  which  occafions  the  hot  one  •,  as 
well  as  the  degree  of  fuch  torpor  or  exertion,  are  perhaps  more 
material  than  the  time  of  their  duration.  Befides  this,  fome 
rnufcles  are  lefs  liable  to  accumulate  fenforial  power  during  their 
torpor,  than  others,  as  the  locomotive  mufcles  compared  with 
the  capillary  arteries  j  on  all  which  accounts  a  long  cold  fit  may 
often  be  followed  by  a  fhort  hot  one. 

As  the  torpor,  with  which  a  fit  of  fever  commences,  is  feme- 
times^  owing  to  defeft  of  ftimulus,  as  in  going  into  the  cold- 
bath  5  and  fometimes  to  a  previous  exhauflion  of  the  fenforial 
power  by  the  action  of  fome  violent  ftimulus,  as  after  coming 
out  of  a  hot  room  into  cold  air  •,  a  longer  time  muft  elapfe,  be- 
fore there  can  be  a  fufficient  accumulation  of  fenforial  power  to 
produce  a  hot  fit  in  one  cafe  than  in  the  other.  Becaufe  in  the 
latter  cafe  the  quantity  of  fenforial  power  previoufly  expended 
rnuft  be  fupplied,  before  an  accumulation  can  begin. 

The  cold  paroxyfm  commences,  when  the  torpor  of  a  part  be- 
comes fo  great,  and  its  motions  in  confequence  fo  flow  or  feeble, 
as  not  to  excite  the  fenforial  power  of  affociation  5  which  in 
health  contributes  to  move  the  reft  of  the  fyftem,  which  is  •ite- 
nated  with  it.  And  the  hot  fit  commences  by  the  accumulation  of 
the  fenforial  power  of  irritation  of  the  part  firft  affected,  either 
ib  as  .to  counteract  its  deficient  ftimulus,  or  its  previous  wafte  of 
fenforial  power  ;  and  it  becomes  general  by  the  accumulation  of 
the  fenforial  power  of  afTociation  ;  which  is  excited  by  the  reno- 
vated-actions  of  the  part  firft  affeded  j  or  becomes  fo  great  as  to- 
overbalance  the  deficient  excitement  cf  it.  On  all  thefe  accounts 
the  hot  fit  cannot  be  fuppofed  to  bear  any  proportion  to  the  cold 
one  in  length  of  time,  though  the  latter  may  be  the  confequence 
of  the  former.  See  Suppl.  I.  16.  8. 

SPECIES. 

1.   Felris  irritativa.     Irritative  fever.     This  is  the  fynocha  of 
fome  writers,  it  is  attended  with  ftrong  piilie  without  inflama- 
tion  ;    and  in  this  circumftance  differs  from  the  febris  inirritativa 
ofClalsI.  2.  i.  T.  which  is  attended  with  weak  pulfe  without 
inflammation.     The  increafed  frequency  of  the  pulfation  of  the 
heart  and  arteries  conftitutes  fever  ;  during   the  cold   fit  thefe 
pulfations  are  always  weak,  as  the  energy  of  action  is  then  de- 
d  throughout  the  whole  fyftem  •,  and  therefore  the  gener- 
al 


CLASS  I.  i.  i.  2.          07  IRRITATION.  n 

al  arterial  ftrength  cannot  be  determined  by  the  touch,  till  the 
part  of  the  parcxyfm  ceafes.  This  determination  is  fome- 
times  attended  with  difficulty ;  as  ftrong  and  weak  are  only  com- 
parative ae  grees  of  the  greater  or  Ids  refiftance  of  the  pulfation 
of  the  artery  to  the  compreilion  of  the  finger.  But  the  greater 
or  lefs  frequency  of  the  pulfations  affords  a  collateral  evidence 
in  thofe  caies,  where  the  degree  of  ftrength  is  not  very  diftin- 
guifhable,  which  may  arTift  cur  judgment  concerning  :c.  Since 
a  moderatelv  ilrong  pulfe,  when  the  patier.t  is  in  a  recumbent 
pofture,  and  not  hurried  in  mind,  feldom  exceeds  120  ilrokes  in 
a  minute  ;  whereas  a  weak  one  often  exceeds  130  in  a  recum- 
bent poflure,  and  150  in  an  eredl  one,  in  thofe  fevers,  which 
are  termed  nervous  or  putrid.  See  Seel.  XII.  i.  4. 

The  increafcd  frequency  of  the  pulfatien.  of  the  heart  and  ar- 
teries, as  it  is  occafioned  either  by  excefs  or  defect  of  ftimiilus,  or 
of  fenforial  power,  exifls  both  in  the  cold  and  hot  fits  of  fever  ; 
but  when  the  cold  fit  ceafes,  and  the  pulfe  becomes  ftrong  and 
full  as  well  as  quick,  in  confequence  of  the  increafed  irritability 
,of  the  heart  and  arteries,  it  conftitutes  the  irritative  fever,  or  fy- 
nocha.  It  is  attended  with  confiderable  heat  during  the  parox- 
yfm,  and  generally  terminates  in  a  quarter  of  a  lunation,  without 
anydifturbance  of  the  faculties  of  the  mind.  SeeClafsIV.  i.  1.8. 

M.  M.  Venefetlion.  Emetics.  Cathartics.  Cool  the  patient 
in  the  hot  fit,  and  warm  him  in  the  cold  one.  Reft.  Torp, 

2.  Ebrittas.     Drunkennefs.     By  the  ftimulus  of  wine  or  opi- 
um the  whole  arterial  fyftem,  as  well  as  every  other  part  of  the 
moving  fyftem,  is  excited  into    increafed  action.     All  thefe  fe~ 
cretions,  and  with  them  the  production  of  fenforial  power  itfelf 
in  tlvj  brain,  feem  to  be  for  a  time  increafed,  with  an  additional 
quantity  of  heat,  and  of   pleafurable  fenfation.     See  Seel:.  XXI. 
on  this  kibjecl.     This  explains,  why  at  the  commencement  of 
the  warm  paroxyfm  of  fome  fevers  the  patient  is  in  greater  fpir- 
its,  or  vivacity ;   becaufe,  as  in  drunkennefs,  the  irritative  motions 
are  all  increafed,  and  a  greater  production  of  fenfation  is  the  con- 
fequence, which,  when  in  a  certain  degree,  is    pleafurable,  as  in 
the  diurnal  fever  of  weak  people.     Sect.  XXXVI.  3.1. 

3.  Hcemorrbagia  arteriofa.     Arterial  haemorrhage.     Bleeding 
with  a  quick,  ftrong,  and  full   pulfe.     The   hemorrhages  from 
the  lungs,  and  from  the  nofe,  are  the  molt  frequent  of  thefe  -,  but 
it  fometimes  happens,  that  a  fmall  artery  but  half.divided,  or  the 
puncture  of  a  leech,  will  continue  to  bleed  pertinacioufly. 

M.  M.  Venefe£lion.     Cathartic  with  calomel.     Divide   the 
wounded  artery.     Bind  fponge  on  the  puncture.     If  coffee  or 
,  internally  ?      If  air,  with  leis  oxygen  ? 

4.  Hjemtyt-:?  arteriofa.     Spitting  of  arterial  blood.     Blood  fpit 


4.2  DISEASES  CLASS  I.  i.  *.  5, 

.up  from  the  lungs  is  florid,  becaufe  it  has  juft  been  expofed  to  the 
influence  of  the  air  in  its  paiTage  through  the  extremities  of  the 
pulmonary  artery  •,  it  is  frothy,  from  the  admixture  of  air  with  it 
in  the  bronchia.  The  patients  frequently  vomit  at  the  fame  time 
from  the  difagreeable  titillatipn  of  blood  aboutthe  fauces  ;  and  are 
thence  liable  to  believe,  that  the  blood  is  ejected  from  the  ftomach. 
Sometimes  an  hsemoptoe  for  feveral  fucceffive  days  returns  in 
gouty  perfons  without  danger,  and  feems  to  fupply  the  place  of 
the  gouty  paroxyfms.  Is  not  the  liver  always  difeafed  previous 
to  the  hsmioptoe,  as  in  feveral  other  haemorrhages  ?  See  Clafs 

I.  2.    I.  9. 

M.  M.  VenefecUow,  a  purge,  a  blifter,  diluents,  torpentia  ; 
and  afterwards  forbentia,  as  the  bark,  the  acid  of  vitriol,  and 
opium.  An  emetic  is  faid  to  flop  a  pulmonary  haemorrhage, 
which  it  may  efFe£l,  as  ficknefs  decreafes  the  circulation,  as  is 
very  evident  in  the  great  ficknefs  fometimes  produced  by  too  large 
a  dofe  of  digitalis  purpurea. 

Dr.  Rum  fays,  a  table-fpponful  or  two  of  common  fait  is  fuc- 
cefsful  in  haemoptoe ;  this  may  be  owing  to  its  ftimulating  the 
abforbent  fyftems,  both  the  lymphatic,  and  the  venous.  Should 
the  patient  refpire  air  with  lefs  oxygen  ?  or  be  made  fick  by 
•whirling  round  in  a  chair  fufpended  by  a  rope  ?  One  immer- 
fion  in  cold  water,  or  a  fudden  fprinkling  all  over  with  cold 
water,  would  probably  flop  a  pulmonary  hcemprrhage.  Sec 
Sea.  XXVII.  i. 

5.  H&morrhagia  narium.  Epiftaxis.  Bleeding  at  the  nofe  in, 
elderly  fubjects  moft  frequently  attends  thofe,  whofe  livers  are 
enlarged  or  inflamed  by  the  too  frequent  ufe  of  fermented  liquors. 

In  boys  it  occurs  perhaps  fimply  from  redundancy  of  blood ; 
and  in  young  girls  fometimes  precedes  the  approach  of  the  cata- 
jnenia ;  and  then  it  (hews  a  difpofition  contrary  to  chlorofis ; 
which  arifes  from  a  deficiency  of  red  blood. 

M.  M.  It  is  flopped  by  plunging  the  head  into  cold  water, 
with  powdered  fait  haftily  diflblved  in  it ;  or  fometimes  by  lint 
ftrewed  over  with  wheat  flower  put  up  the  noftrils  ;  or  by  a  folu- 
tion  of  fteel  in  brandy  applied  to  the  vefTel  by  means  of  lint.  The 
cure  in  other  refpeclis  as  in  hjemoptoe  ;  when  the  bleeding  recurs 
at  certain  periods,  after  venefecl:ion,  and  evacuation  by  calomel, 
and  a  blifter,  the  bark  and  fteel  muft  be  given,  as  in  intermittent 
fevers.  See  Sedion  XXVII.  i. 

The  tindlure  of  digitalis  given  in  proper  quantities,  as  30 
drops  from  a  two-ounce  phial  every  fix  hours  for  two  or  three  or 
four  dofes,  is  probably  an  efficacious  medicine.  See  Dr.  Ferri- 
ar's  Treatife  on  Digitalis.  He  flopped  ad~live  haemorrhages  by 
the  exhibition  of  digitalis, 

ORDCX 


tlsLj.2.  i.         OF  IRRITATION.  T3 

-ORDO    I. 

Increafed  Irritation. 

GENUS     II. 
With  Increafed  Afiipns  of  the  Secerning  Syfem. 

THESE  are  always  attended  with  increafe  of  partial  or  of  gen* 
tral  heat ;  for  the  fecreted  fluids  are  not  (imply  feparated  from 
the  blood,  but  are  new  combinations  ;  as  they  did  not  previoufly 
exift  asfuch  in  the  blood  veflels.  But  all  new  combinations  give 
out  heat  chemically ;  hence  the  origin,  of  animal  heat,  which 
is  always  inc^eafed  in  proportion  to  the  fecretion  of  the  part 
affected,  or  to  the  general  quantity  of  the  fecretions.  Neverthe- 
lefs  there  is  reaibn  to  believe,  that  as  we  have  a  fenfe  purpofely 
to  diftinguilh  the  prefence  of  greater  or  lefs  quantities  of  heat, 
as  mentioned  in  Seel.  XIV.  6.  fo  we  may  have  certain  minute 
glands  for  the  fecretion  of  this  fluid,  as  the  brain  is  believed  to 
fecrete  the  fenforial  power,  which  would  more  eafily  account  for 
the  inftantaneous  production  of  the  blufh  of  (hame,  and  of  an- 
ger. This  fubjeft  deferves  further  investigation. 

SPECIES. 

1 .  Color  felr ills.     The  heat  in  fevers  arifes  from  the  mcreafc 
of   fome    fecretion,    either    of   the   natural   fluids,  as  in  irrita- 
tive fevers  ;  or  of  new  fluids,  as  in  infectious  fevers  ;  or  of  new 
veflels,  as  in  inflammatory  fevers.     The  pain  of  heat  is  a  confe- 
quence  of  the   increafed  extenfion  or  contraction  of  the  fibres 
expofed  to  fo  great  a  ftimulus.     See  Clafs  I.   i.  5.  6. 

2.  Ruborfebrilts.    Febrile  rednefs.    When  the  cold  fit  of  fe- 
ver terminates,  and  the  pulfations  of  the  heart  and  arteries  be- 
come ftrong  as  well  as  quick  from  the  increafe  of  their  irritabili- 
ty after  their  late  quiefcence,  the  blood  is  impelled  forwards  in- 
to t'he  fine  extremities  of  the  arteries,  and  the   anaftainofmg  ca- 
pillaries, quicker   than  the  extremities  of  the  veins  can  abforb 
and  return  it  to  the  heart.     Hence  the  pulfe  at  the  wriil  becomes 
full,  as  well  as  quick  and  ftrong,   and  the  (kin  glows  with  arte- 
rial blood,  and  the  veins  become  empty  and  lefs  vifible. 

In  elderly  people  the  force  of  the  heart  and  arteries  becomes 
lefs,  while  the  abforbent  power  of  the  veins  remains  the  fame  ; 
whence  the  capillary  veflels  part  with  the  blood,  as  foon  as  it  is 
Deceived,  and  the  fkin  in  confequence  becomes  paler  \  it  is  alfo 

probable, 


:4  DISEASES  CLASS  I.  i.  2.  3. 

probable,  that  in  more  advanced  life  fome  of  the  finer  branches 
of  the  arteries  coalefce,  and  become  impervious,  and  thus  add  to 
the  opacity  of  .the  fkin. 

3.  Sudor  calidus.  Warm  fweat  may  be  .divided  into  four  va- 
rieties, according  to  its  remote  caufes.  Firfty  the  perfpirable 
matter  is  feoreted  in  as  great  quantity  during  the  hot  fit  of  fever, 
as  towards  the  end  of  it,  when  the  fweat  is  feen  upon  the  fkin. 
But  during  the  hot  jit  the  cutaneous  ab foments  act  alfo  with  in- 
creaied  energy,  and  the  exhalation  is  likewife  increafed  by  the 
greater  heat  of  the  fkin  j  and  hence  it  does  not  appear  in  drops 
on  the  furface,  but  is  in  part  re-abforbed,  and  in  part  diflipated 
in  the  atmofphere.  But  as  the  mouths  of  the  cutaneous  abforb- 
ents  are  expofed  to  the  cool  air  or  bedclothes  ;  whilft  thofe  of 
the  cr.piiiary  glands,  which  fecrete  the  perfpirable  m.itter,  are  ex- 
pofed to  the  warmth  of  the  circulating  blood  ;  the  former,  as 
foon  as  the  fever-fit  begins  to  decline,  lofe  their  increafed  action 
•firft,  and  hence  the  abiorption  of  the  fweat  is  diminiihed,  whild 
the  incr.eafed  fecretion  of  it  continues  for  fome  hours  afterwards, 
which  occafions  it  to  ftand  in  drops  upon  the  fkin. 

As  the  /kin  becomes  cooler,  the  evaporation  of  the  perfpira- 
ble matter  becomes  lefs,  as  \vell  as  the  abforption  of  it.  And 
hence  the  diffipation  of  aqueous  fluid  from  the  body,  and  the 
confequent  third,  are  perhaps  greater  during  the  hot  fit,  than 
during  the  fubfequent  fweat.  For  the  fweats  do  not  occur,  ac- 
cording to  Dr.  Alexander's  experiments,  till  the  {kin  is  cooled 
from  1 12  to  1 08  degrees  of  heat ;  that  is,  till  the  paroxyfm  be- 
gins to  decline.  From  this  it  appears,  that  the  fweats  are  not 
critical  to  the  hot  fit,  any  more  than  the  hot  fit  can  be  called 
critical  to  the  cold  one  -,  but  fimply,  that  they  are  the  natural 
confluence  of  the  decline  of  the  hot  fit,  commencing  with  the 
decreafed  action  of  the  abforbent  fyftem,  and  the  decreafed  evap- 
oration from  the  (kin.  And  from  hence  it  may  be  concluded, 
that  a  fever-fit  is  not  in  general  an  effort  of  nature  to  reftore 
health,  as  Sydenham  confidered  it,  but  a  neceffary  confequence 
of  the  previous  torpor ;  and  that  the  caufes  of  fevers  would  be 
lefs  detrimental,  if  the  fever  itfelf  could  be  prevented  from  exj(l> 
ing  •,  as  appears  in  the  cool  treatment  of  the  fmall-pox. 

It  muft  be  noted  that  the  profufe  fweats  on  the  1km  are  more 
frequent  at  the  decline  of  fever-fits  than  the  copious  urine,  or 
looie  ilools,  which  are  mentioned  below  ;  as  the  cutaneous  ab- 
forbents,  being  expofed  to  the  cool  air,  lofe  their  increafed  ac- 
tion {boner  than  the  urinary  or  inteflinal  abforbents  *,  which 
open  inro  the  warm  cavities  of  the  bladder  and  inteftines  ;  but 
which  are  neverthelefs  often  affected  by  their  fympathy  with  the 
cutaneous  abforbents.  Hence  few  fevers  terminate  without  a 

moiilure 


CLASS  I.  r.  2.  3.  OF  IRRITATION.  :; 

moifture  of  the  (kin  ;  whence  arofe  the  fatal  practice  of 
forcing  fweats  by  the  external  warmth  of  air  or  bed-clothes  in 
rs  ;  for  external  warmth  increafes  the  action  of  the  cutane- 
ous capillaries  more  than  that  of  the  other  fecerning  veflels  ;  be- 
caufe  the  latter  are  habituated  to  98  degrees  of  heat,  the  inter- 
nal warmth  of  the  body  ;-  whereas  the  cutaneous  capillaries  be- 
inc;  nearer  the  furface  are  habitually  kept  cooler  by  the  contact 
ofthe  external  air.  Sweats  thus  produced  by  heat  in  confined 
rooms  are  (till  more  detrimental ;  as  the  air  becomes  then  not 
only  deprived  of  a  part  of  its  o.v  frequent  refphation, 

but  is  loaded  wirh  ?.nimal  effluvia  as  well  as  with  moifture,  till 
it  can  receive  no  more  ^  and  in  confequence,  while  the  cutane- 
ous fecretion  (lands  upon  the  fkin  in  drops  for  want  of  exhala- 
tion, the  lungs  are  expofed  to  an  infalubrious  atmofphere. 

I  do  not  deny,  that  fweating  may  be  fo  managed  as  to  be 
ferviceable  in  preventing  the  return  of  the  cold  paroxyifm  of  fe- 
vers ,  like  the  warm  bath,  or  any  other  permanent  ftimulus,  as 
wine,  or  opium,  or  the  bark.  For  this  purpofe  it  ihould  be  con- 
tinued till  paft  the  time  of  the  expected  cold  fit,  fupported  by 
moderate  dofes  of  wine-whey,  with  fpirit  of  hartmorn,  and  mod- 
erate degrees  of  warmth.  Its  falutary  effect,  when  thus  man- 
aged, was  probably  one  caufe  of  its  having  been  fo  much  attend- 
ed to  ;  and  the  fetid  fmell,  which  when  profufe  is  liable  to  ac- 
company it,  gave  occafion  to  the  belief,  that  the  fuppofed  mate- 
rial caufe  of  the  difeafe  was  thus  eliminated  from  the  circulation. 

When  too  great  external  heat  is  applied,  the  fyftem  is  weak- 
ened by  excefs  of  action,  and  the  torpor  which  caufes  the  cold 
paroxyfm  recurs  fooner  and  more  violently.  For  though  fome 
flimuli,  as  of  opium  and  alcohol,  at  the  fame  time  that  they  ex- 
hauft  the  fenforial  power  by  promoting  increafe  of  fibrous  action, 
may  alfo  increafe  the  production  or  fecretion  of  it  in  the  brain, 
yet  experience  teaches  us  that  the  exhauftion  far  out-balances 
the  increafed  production,  as  is  evinced  by  the  general  debility, 
which  fucceeds  intoxication. 

In  refpect  to  the  fetor  attending  copious  continued  fweats,  it 
is  owing  to  the  animalized  part  of  this  fluid  being  kept  in  that 
degree  of  warmth,  which  molt  favours  putrefaction,  and  not  fuf- 
fered  to  exhale  into  the  atmofphere.  Broth,  or  other  animal 
mucus,  kept  in  fimilar  circumftances,  would  in  the  fame  time 
acquire  a  putrid  fmell  ;  yet  has  this  error  frequently  produced 
miliary  eruptions,  and  increafed  every  kind  of  inflammatory  or 
fenfitive  fever. 

The  cafe,  which  the  patient  experiences  during  fweating,  if 
it  be  not  produced  by  much  external  heat,  is  fimiiar  to  that  of 
the  warm  bath  j  which  by  its  ftimulus  applied  to  the  cutaneous 

veflels, 


1  6  DISEASES  CLASS!,  i.: 


veffels,  which  are  generally  cooler  than  the  internal  parts 
fyftem,  excites  them  into  greater  action  ;  and  pleafurable  fenfa- 
tion  is  the  confequence  of  thefe  increafed  actions  of  the  vefiels 
of  the  (kin.  From  confiderrng  all  thefe  circumftances,  it  ap- 
pears that  it  is  not  the  evacuation  by  fweats,  but  the  continued 
ftimulus,  which  caufes  and  fupports  thole  fweats,  which  is  fer- 
viceable  in  preventing  the  returns  of  fever-fits.  And  that  fweats 
too  long  continued,  or  induced  by  too  great  ftimulus  of  warmth, 
clothes,  or  medicines,  greatly  injure  the  patient  by  increafmg  in- 
flammation, or  by  exhaufting  the  fenforial  power.  See  Glafs  I. 
I.  2.  14. 

Secondly,  The  fweats  produced  by  exercife  or  labour  are  of 
the  warm  kind  ;  as  they  originate  from  the  increafed  action  of 
the  capillaries  of  the  (kin,  owing  to  their  being  more  powerfully 
itimulated  by  the  greater  velocity  of  the  blood,  and  by  a  greater 
quantity  of  it  paffing  through  them-  in  a  given  time  For  the 
blood  during  violent  exercife  is  carried  forwards  by  the  action 
of  the  mufcles  fafter  in  the  arteries,  than  it  can  be  taken  up  by 
the  veins  ;  as  appears  by  the  rednefs  of  the  fkin.  And  from 
the  confequent  fweats,  it  is  evinced,  that  the  fecretory  veiTels  of 
the  fkin  during  exercife  pour  out  the  perfpirable  matter  fafter, 
than  the  mouths  of  the  abforbent  veifels  can  drink  it  up.  Which 
mouths  are  riot  expofed  to  the  increafed  mufcular  action,  or  to 
the  ftimulus  of  the  increafed  velocity  and  quantity  of  the  blood* 
but  to  the  cool  air. 

Thirdly^  the  increafed  fecretion  of  perfpirable  matter  occafion- 
ed  by  the  ftimulus  of  exteral  heat  belongs  likewife  to  this  place  5 
as  it  is  caufed  by  the  increafed  motions  of  the  capillary  veffels  5 
•which  thus  feparate  from  the  blood  more  perfpirable  matter, 
than  the  mouths  of  their  correfpondent  abforbent  veffels  can  take 
up  ;  though  thefe  alfo  are  ftimulated  by  external  heat  into  more 
energetic  action.  If  the  air  be  ftationary,  as  in  a  fmall  room, 
or  bed  with  clofed  curtains,  the  fweat  {lands  in  drops  on  the  fkin 
for  want  of  a  quicker  exhalation  proportioned  to  the  quicker  fe* 
cretion. 

A  fourth  variety  of  warm  perfpiration  is  that  occafioned  by 
llimulating  drugs,  of  which  opitfm  and  alcohol  are  the  moft 
powerful  ;  and  next  to  thefe  the  fpices,  volatile  alkali,  and  neu- 
tral falts,  efpecially  fea-falt  ;  that  much  of  the  aqueous  part  of 
the  blood  is  diffipated  by  the  ufe  of  thefe  drugs,  is  evinced  by  the 
great  thirft,  which  occurs  a  few  hours  after  the  ufe  of  them.  Sea 
Art.  III.  2.  i. 

We  may  from  hence  underftand,  that  the  increafe  of  this 
fecretion  of  perfpirable  matter  by  artificial  means,  muft  be  fol- 
lowed by  debility  and  emaciation.  When  this  is  done  by  taking 

much 


CLASS  I.  i.  2.  3.       OF  IRRITATION.  17 

inach  fait,  or  falted  meat,  the  fea-fcurvy  is  produced  ;  which 
confiit i  in  the  inirritability  of  the  bibulous  terminations  of  the 
Veins  arifing  from  the  capillaries  j  fee  Clafs  I.  2.  i.  14.  Tha 
fcrofula,  or  inirritability  of  the  lymphatic  glands,  feems  alib  to  be 
occafion-illy  induced  by  an  excefs  in  eating  fait  added  to  food  of 
bad  nouri  foment.  See  Clafs  I.  2'.  3.  21.  If  an  excefs  of  per- 
fpiration  is  induced  by  warm  or  ftimulant  clothing,  as  by  wear- 
ing flannel  in  contact  with  the  (kin  in  the  fiimmer  months,  a  per- 
petual febricula  is  excited,  both  by  the  preventing  the  accefs  of 
cool  air  to  the  {kin,  and  by  perpetually  goading  it  by  the  numerous 
and  hard  points  of  the  ends  of  the  wool  j  which  when  applied  to 
the  tender  fkinsof  young  children,  frequently  produce  the  red 
gum,  as  it  is  called  ;  and  in  grown  people,  either  an  eryfipe- 
las,  or  a  miliary  eruption,  attended  with  fever.  See  Ciafs  II. 
i.  3.  12. 

Shirts  made  of  cotton  or  calico  ftimulate  ths  (kiri  too  much 
by  the  points  of  the  fibres,  though  lefs  than  flannel  ;  whence 
cotton  handkerchiefs  make  the  note  fore  by  frequent  ufe.  The 
fibres  of  cotton  are,  I  fuppofe,  ten  times  fhorter  than  thofe  of 
flax,  and  the  number  of  points  in  confequence  twenty  times  the 
number;  and  though  the  manufacturers  fmge  their  calicoes  on  a 
red-hot  iron  cylinder,  yet  I  have  more  than  once  teen  an  eryiip- 
elas  induced  or  increaied  by  the  ftimulus  of  calico,  as  well  as  of 
flannel  j  and  have  during  the  lail  fummer  prevailed  on  two,  who 
were  confined  to  their  beds  by  fevers,  and  three,  who  were  in  a 
ftate  of  great  debility,  to  difencumber  themfeJves  of  the  flan- 
nel Hurts,  which  they  had  worn  for  fome  time  j  all  of  them  be- 
came immediately  and  confiderably  relieved  ;  and  found  no  in- 
convenience afterwards  by  difcontinuing  an  unneceflary  ftimulus, 
•which  had  nothing  to  recommend  it  to  thofe  patients  but  the 
frivolous  fafhion  of  the  day. 

The  inconvenience^  which  weak  conftitutions  experience  frorri 
wearing  flannel  fhirts,  arifes  from  this  circumitance  5  that  the  ex- 
tremities of  their  limbs  are  more  liable  to  become  cold,  than  the 
furface  of  the  cheil  and  abdomen,  and  that  hence  they  fhould  in 
preference  wear  warmer  (lockings,  (hoes,  and  focks,  or  gloves. 
By  ilimulating  the  warmer  parts  of  the  (kin  into  too  ftrong  and 
iifelefs  exertion,  as  by  the  hard  points  of  a  flannel  fnirt  at  ali  iea- 
fons,  and  by  its  confining  the  warmth  of  the  (kin  too  much  i:i 
the  fummer  months,  a  part  of  the  fcnforial  power  becomes  un- 
neceflarily  expended  ;  and  in  weak  conftitutions,  where  there  is 
none  to  fpare,  fome  other  parts  of  the  fyftem  mud  act  with  Icfs 
energy  ;  and  thus  I  believe  the  extremities  of  feeble  people  be- 
come colder  by  the  ufe  of  a  flannel  fliirt ;  in  ftronger  people,  and 
perhaps  in  warmer  climates,  this  increafsd  cakiaefs  of  the  e.t- 

Vol.  II.  D  treuiiti"., 


1 8  DISEASES  CLASS  I.  i.  2.  £ 

tremities  may  not  be  perceptible ;  as  flronger  perfons  can  better 
bear  fome  iucreafed  exertion,  and  the  confequent  unneceflary  lofs 
of  fome  fenforial  power ;  and  in  warmer  climates  the  extremi- 
ties may  not  be  fo  liable  to  become  cold. 

Analogous  to  this  I  remember  to  have  feen  an  inoculated  child 
about  fix  years  old,  whofe  bofom  and  face,  at  the  beginning  of  the 
eruptive  fever,  were  of  a  fiery  red  colour,  and  exceedingly  hot  to 
the  touch ;  and  whofe  feet  were  at  the  fame  time  pale,  and  cold 
to  the  touch.  When  on  expofmg  the  bofom  and  face  to  colder 
air  with  the  feet  only  {lightly  covered,  the  colour  of  the  former  in 
a  few  minutes  became  nearly  natural,  with  little  excefs  of  tangi- 
ble heat,  and  at  the  fame  time  the  feet  became  as  warm  as  natural. 

Whence  I  conclude,  that  all  unneceffary  increafe  of  ftimuli,  as 
of  warm  clothing,  wine,  and  opium,  is  more  injurious  to  fee- 
ble conftitutions  than  to  robuft  ones  ;  and  that  fuch  ilimuli  alone 
are  falutary  to  weak  perfons,  ao  increafe  thofe  actions  of  the  fyf- 
tem,  which  are  immediately  neceflary  to  life  and  health,  as  the 
clafs  of  medicines  termed  forbentia,  as  peruvian  bark,  and  other 
bitters,  and  very  fmall  quantities  of  fteel,  as  thefe  feem  to  increafe 
the  activity  of  the  abforbent  fyftem,  both  of  the  lymphatic  and 
venous  ones,  and  thus  fupply  more  nutrition,  with  all  its  falutary 
confequences.  And  that  the  ufe  of  thefe  forbentia,  as  well  as  of 
the  occafional  ufe  of  warmer  clothing,  wine,  and  opium,  fhould 
be  difcontinued,  as  foon  as  the  fyftem  can  acquire  the  natural 
habit  of  acling  with  fufficient  energy  without  them.  See  Article 
II.  2.  2.  i.  of  the  Materia  Medica. 

The  increafe  of  perfpiration  by  heat  either  of  clothes,  or  of  fire,, 
contributes  much  to  emaciate  the  body  ;  as  is  well  known  to  jock- 
eys, who,  when  they  are  a  ftone  or  two  too  heavy  for  riding, 
find  the  quickeft  way  to  lefTen  their  weight  is  by  fweating  them- 
felves  between  blankets  in  a  warm  room  j  but  this  likewife  is  a 
pradtice  by  no  means  to  be  recommended,  as  it  weakens  the  fyf- 
tem by  the  excefs  of  fo  general  a  ftimulus,  brings  on  a  premature 
old  age,  and  mortens  the  fpan  of  life  ;  as  raay  be  further  deduced 
from  the  quick  maturity,  and  fhortnefs  of  the  lives,  of  the  inhab- 
itants of  Hindoftan,  and  other  tropical  climates. 

When  the  heat  of  the  body  in  weak  patients  in  fevers  is  incrcaf- 
ed  by  the  ftimulus  of  the  points  of  flannel,  a  greater  eonfequent 
debility  fucceeds,  than  when  it  is  produced  by  the  warmth  of 
fire  ;  as  in  the  former  the  heat  is  in  part  owing  to  the  increafed 
activity  of  the  (kin,  and  confequent  expenditure  of  fenforial  pow- 
er ;  whereas  in  the  latter  cafe  it  is  in  part  owing  to  the  influx  of 
the  rluki  matter  of  heat. 

So  the  warmth  produced  by  equitation,  or  by  rubbing  the  body 
and  limbs  with  a  frnooth  bruih  or  hand,,  as  is  done  after  bathing 


CLASS  L  i.  2.  4-       OF  IRRITATION.  19 

in  fome  parts  of  the  Haft,  does  not  expend  nearly  fo  much 
!  power,  as  when  the  warmth  is  produced  by  the  loc 
tion  of  the  whole  weight  of  the  body  by  mufcular  action,  as  in 
walking,  or  running,  or  fwimming.     Whence  the  warmth  of  a 
fire  is  to  be  preferred  to  flannel  {khts  for  weak  people,  and  the 

.tion  of  a  horfe  :to  exereife  on  foot.     And  I  fuppofe  v 
who  are  unfortunately  loft  in  fnow,  who  are  on   foot,  are 
to  perifli  fooner  by  being  exhaufted  by  their  mufcular  exertions  ; 
and  might  frequently  preferve  themfelves  by  lying  on  the  ground, 
.and  covering  themfelves  with  fnow,  before  they  were  too  much, 
exhaufted  by  fatigue.     See  Botari.  Garden,  Vol.  II.  the  note  on 
netz. 

M.  BuiTon  made  a  curious  experiment  to  (hew  this 
fiance.     He  took  a  numerous  brood  of  the    butterflies  of 
worms,  fome  hundreds  of  which  left  their  eggs  on  the  fame  day 
and  hour ;  thefe  he  divided  into  two  parcels  ;  and  placing  on 
eel  in  the  fouth  window,  and  the  other  in  the  north  window  - 
houfe,  he  obferved,  that  thofe  in  the  colder  iituation  lived  many 
days  longer  than  thofe  in  the  warmer  one.     From  thefe  obferva- 
tioni.it  appears,  tLat  the  wearing  of  flannel  clothing  next  the  fkin, 
which  is  now  fo  much  in  falhion,  however  ufefui   it  may  be  in 
the  winter  to  thofe,  who  have  cold  extremities,  bad  digeftions,  or 
habitual  coughs,  muft  greatly  debilitate  them, if  worn  in  the  warm 
months,  producing  fevers,  eruptions,  and  premature  old  age. 
See  Sea.  XXXVII.  5.  Clafs  I.  i.  2.  14.     Art.  III.  2.  i. 

4.  Urina  uberior  colorata.  Copious  coloured  urine.  To- 
wards the  end  of  fever-fits  a  large  quantity  of  high  coloured 
urine  is  voided,  the  kidneys  continuing  to  act  ftrongly,  after  the 
increafed  action  of  the  abforbents  of  the  bladder  is  fume; 
diminifhed.  If  the  abforbents  continue  alfo  to  aft  ftrongly,  the 
urine  is  higher  coloured,  and  fo  leaded  as  to  depofit,  when  cool, 
an  earthy  fediment,  erroneoufly  thought  to  be  the  material  caufe 
of  the  difeafe  j  but  is  fimply  owing  to  the  fecretion  of  the  kid 
being  great  from  their  increafed  action ;  and  the  thinner  parts 
of  it  being  abforbed  by  the  increafed  action  of  the  lymphatics, 
which  are  fpread  very  thick  on  the  neck  of  the  bladder ;  for  the 
urine,  as  well  as  perhaps  all  the  other  fecreted  fluids,  is  produced 
from  the  kidneys  in  a  very  dilute  ftate  ;  as  appears  in  thofe, 
who  from  the  ftimulus  of  a  ftone,  or  other  caufe,  evacuate  their 
urine  too  frequently;  which  is  then  pale  from  its  not  having 
remained  in  the  bladder  long  enough  for  the  more  aqueous  part 
to  have  been  re-abforbed.  The  general  ufe  of  this  urinary  ab- 
forption  to  the  animal  ceconomy  is  evinced  from  the  urinary  blad- 
ders of  fifh,  which  would  otherwife  be  unneceflary.  High  col- 
oured urine  in  large  quantity  fhews  only,  that  the  fecreting  vef- 


20  DISEASES  CLASS  I.  i.  2.  5, 

fels  of  the  kidneys,  and  the  abforbents  of  the  bladder,  have  a^e  t 
with  greater  energy.  When  there  is  much  earthy  fediment,  it 
ihews,  that  the  abforbents  have  acled  proportionally  ftronger, 
and  have  confequently  left  the  urine  in  a  lefs  dilute  frate.  Iii 
this  urine  the  tranfparent  fediment  or  cloud  is  mucous  •>  the 
opaque  fediment  is  probably  coagulable  lymph  from  the  blood 
changed  by  an  animal  or  chemical  procefs.  The  floating  fcum 
is  oil.  The  angular  concretions  to  the  fides  of  the  pot,  iormed 
as  the  urine  cools,  is  microcofmic  fait.  £)oes  the  adhefive  blue 
matter  on  the  fides  of  the  glafs,  or  the  blue  circle  on  it  at  the 
edge  of  the  upper  furface  of  the  urine,  confift  of  Pruffian  blue  ? 

5.  Diarrhoea  calida.  Warm  diarrhoea.  This  fpecies  may 
be  divided  into  three  varieties,  deduced  from  their  remote  caufes, 
under  the  names  of  diarrhoea  febrilis,  diarrhoea  crapulofa,  and 
diarrhoea  infantum.  The  febrile  diarrhoea  appears  at  the  end 
of  fever-fits,  and  is  erroneoufly  called  critical,  like  the  copious 
urine,  and  the  fweats  ;  whereas  it  arifes  from  the  increafed  action 
of  thofe  fecerning  organs,  which  pour  their  fluids  into  the  intef- 
tinal  canal  (as  the  liver,  pancreas,  and  mucous  glands,)  contin- 
uing longer  than  the  increafed  action  of  the  inteftinal  abforbents. 
In  this  diarrhoea  there  is  no  appearance  of  curdled  chyle  in  th$ 
ilools,  as  occurs  in  cholera.  I.  3.  i.  5. 

The  diarrhoea  crapulofa^  or  diarrhoea  from  indigeftion,  occurs 
•when  too  great  a  quantity  of  food  or  liquid  has  been  taken  ; 
which  not  being  completely  digeiled,  flimulates  the  inteftines 
like  any  other  extraneous  acrid  material  ;  and  thus  produces  an 
increafe  of  the  fecretions  into  them  of  mucus,  pancreatic  juice, 
and  bile.  When  the  contents  of  fhe  bowels  are  flill  more  flim- 
ulant,  as  when  draftic  purges,  or  very  putrefcent  diet,  have  been 
taken,  a  cholera  is  induced.  See  Seel:.  XXIX.  4. 

The  diarrhoea  infafitum,  or  diarrhoea  of  infants,  is  generally 
owing  to  too  great  acidity  in  their  bowels.  Milk  is  found 
curdled  in  the  ftomachs  of  all  animals,  old  as  well  as  young,  and 
even  of  carnivorous  ones,  as  of  hawks,  (Spallanzani.)  And 
at  is  the  gaftric  juice  of  the  calf,  which  is  employed  to  curdle 
milk  in  the  procefs  of  making  cheefe.  Milk  is  the  natural  food 
for  children,  and  muft  curdle  in  their  ftomachs  previous  to  di- 
geflion  ;  and  as  this  curdling  of  the  milk  deftroys  a  part  of  the 
acid  juices  of  the  ftomach,  there  is  no  reafon  for  difcontinuing 
the  ufe  of  it,  though  it  is  occafionally  ejected  in  a  curdled  ftate. 
A  child  of  a  week  old,  which  had  been  taken  from  the  breaft  of 
its  dying  mother,  and  had  by  forne  uncommon  error  been  fuf- 
fered  to  take  no  food  but  water-gruel,  became  fick  and  griped 
in  twenty-four  hours,  and  was  convulfed  on  the  fecond  day,  and 
died  on  the  third  !  When  all  young  quadrupeds,  as  well  as 

children, 


,s  I.  i.  2.  6.          OF  IRRITATION.  21 

children,  have  this  natural  food  of  milk  prepared  for  them,  tK* 

;    fo  itrong  in  favour  of  its   falubrity,  that   a    perfoa 

lei  have  powerful  teftimony  indeed  of  its  difagreeing  before 

Ivifes  the  difccr.linuance  of  the  ufe  of  it  to  young  children 

in  health,  and  much  more  fo  in  iickneis.  The  farmers  lofe  many 

of   their  calves,    which   are  brought  up  by  gruel,  or   gruel  and 

old  milk  ;    and  among  the   poor  children   cf  Derby,  who  are 

thus  fed,  hundreds  are  flarved  into  the  fcrqfula,  and  either  perifli, 

or  live  in  a  (late  of  wretched  debility. 

When  young  children  are  brought  up  without  a  bread,  they 
(houid  for  the  firft  tv/o  months  have  no  food  but  new  miJk  ; 
fince  the  addition  of  any  kind  of  bread  or  flour  is  liable  to  fer-. 
ment,  and  produce  too  much  acidity  ;  as  appears  by  the  confe- 
quent  diarrhcea  with  green  dejections  and  gripes  ;  the  colour  is 
owing  to  a  mixture  of  acid  with  the  natural  quantity  of  bile,  and 
the  pain  to  its  itimulus.  And  they  ihould  never  be  fed  as  they 
lie  upon  their  backs,  as  in  that  pofture  they  are  neceffitated  to 
iwailow  all  that  is  put  into  their  mouths  ;  but  when  they  are  fed, 
as  they  are  fitting  up,  or  raifed  up,  when  they  have  had  enough, 
they  can  permit  the  reft  to  run  out  of  their  mouths.  This  cir- 
cumftance  is  of  great  importance  to  the  health  of  thofe  children, 
who  are  reared  by  the  fpoon,  fince  if  too  much  food  is  given 
them,  indigeition,and  gripes,  and  diarrhoea,  are  the  confequence; 
and  if  too  little,  they  become  emaciated  ;  and  of  this  exact 
.<ju.mt.ity  their  own  palates  judge  the  beft. 

M.  M.  In  this  laft  cafe  of  the  diarrhoea  of  children,  the  food 
fhould  be  new  milk,  which  by  curdling  deftroys  part  of  the  acid, 
which  coagulates  it.  Chalk  about  four  grains  every  fix  hours, 
with  one  drop  of  fpirit  of  hartihorn,  and  half  a  drop  of  lauda- 
r.u;Ti.  But  a  blifter  about  the  fize  of  a  milling  is  of  the  greateit 
ferviceby  reftoring  the  power  of  digeftion.  See  Article  III.  2. 
i .  in  the  Materia  Medica. 

6.  Salivatio  callda.  Warm  falivation.  Increafed  fecretion  of 
fiiliva.  This  may  be  eifecled  either  by  (limulating  the  mouth 
of  the  gland  by  mercury  taken  internally  ;  or  by  ftimulating  the 
excretory  duel:  of  the  gland  by  pyrethrum,  or  tobacco;  or  (im- 
rly  by  the  movement  of  the  mufcles,  which  lie  over  the  gland,  as 
in  maflicating  any  taftelefs  fubftance,  as  a  lock  of  wool,  or 
'Lie. 

In  about  the  middle  of  nervous  fevers  a  great  fpitting  of  fali- 

vi  foretimes  occurs,  which  has  been  thought  critical ;  but  as  it 

com.in.ues  fometimes  two  or  even  three  weeks  without  the  relief 

<<f  the  patient,  it  may  be  concluded  to  arife  from  fome   acciden- 

•rcumftance,  perhaps  not  unfimilar  to  the  hyfleric  ptyalifms 

•ioncd  in  Clais  I.  3.  2.  2.  See  Sed.  XXIV. 

M,  M.  Coo] 


22  DISEASES  CLASS  1.1.2.  7: 

M.  M.  Cool  air,  diluents,  warm  bath,  evacuations. 

7.  Cxtarrkus  calidus.      Warm  catarrh.       Confifts  in   an  in- 
creafed  Tecretion  of  mucus  from  the  noftrils  without  inflamma- 
tion.    This  difeafe,  which  is  called  a  cold    in  the   head,  is  fre- 
quently produced  by  cold  air  acting  for  forne  time  on  the  mem- 
branes,   which  line  the  noftrils,  as  it  pafles  to  the  lungs  in  refpi- 
ration.     Whence  a  torpor  of   the  action  of  the  mucous  glands 
is  firlt  introduced,  as  in   Clafs  I.  2.  3.  3.  ,and  an  orp;afm   or  in- 
creafed action  fucceeds  in  confequence.     Afterwards  this  orgafm 
and  torpor  are  liable  to  alternate  with  each  other  for  fome  time 
like  the  cold  and  hot  fits  of  ague,  attended  with  deficient  or  exu- 
berant fecretion  of  mucus  in  the  noftrils. 

At  other  times  it  arifesfrom  reverfe  fympathy  with  fome  ex- 
tenfive  parts  of  the  {kin,  which  have  been  expofed  too  long  to 
cold,  as  of  the  head,  or  feet.  In  confequence  of  the  torpor  of 
thefe  cutaneous  capillaries  thofe  of  the  mucous  membrane  of  the 
noftrils  act  with  greater  energy  by  reverfe  fympathy ;  and  thence 
fecrete  more  mucus  from  the  blood.  At  the  fame  time  the  ab- 
forbents,  acting  alib  with  greater  energy  by  their  reverfe  fym- 
pathy with  thole  of  fome  diftant  part  of  the  fkin,  abforb  the 
thinner  parts  of  the  mucus  more  haftily  ;  whence  the  mucus  is 
both  thicker  and  in  greater  quantity.  Other  curious  circumftan- 
•ces  attend  this  difeafe  ;  the.  membrane  becomes  at  times  fo  thick- 
ened by  its  increafed  aclion  in  fecreting  the  mucus,  that  the  pa- 
tient cannot  breathe  through  his  noftrils.  In  this  fituation  if  he 
v/arms  his  whole  Ikin  fuddenly  by  fire  or  bed-clothes,  or  by- 
drinking  warm  tea,  the  increafed  aclion  of  the  membrane  ceafes 
by  its  reverfe  fympathy  with  the  fkin ;  or  by  the  retraction  of 
the  fenforial  power  to  other  parts  of  the  fyftem  ;  and  the  patient 
can  breathe  again  through  the  noftrils.  The  fame  fometimes  oc- 
curs for  a  time  on  going  into  the  cold  air  by  the  deduction  of 
heat  from  the  mucous  membrane,  and  its  confequent  inactivity 
or  torpor.  Similar  to  this  when  the  face  and  breaft  have  been 
very  hot  and  red,  previous  to  the  eruption  of  the  fmall-pox  by 
inoculation,  and  that  even  when  expoled  to  cool  air,  I  have  cb- 
ferved  the  feet  have  been  cold  ;  till  on  covering  them  with  warm 
flannel,  as  the  feet  have  become  warm,  the  face  has  cooled.  See 
Sea.  XXXV.  i.  3.  Clafs  II.  1.3.5.  IV.  2.  2.10.  IV.  1.1.5. 

M.  M.  Evacuations,  abftmence,  oil  externally  on  the  noie, 
warm  diluent  fluids,  warm  fhoes,  warm  night-cap. 

8.  Expeftwr.tio  calida.     Warm  expectoration  confifts  of  the 
Increafed  fecretion  of  mucus  from  the  membrane,  which  lines 
the  bronchia?,  or  air-cells  of   the  lungs,  without  inflammation. 
This  increafed  mucus  is  ejected  by  the  action  of  coughing,  and 


CLASS  I,  i.  2. 9.         OF  IRRITATK  23 

is  called  a  cold,  and  refembles  the  catarrh  of  the   preceding  arti- 
:   with  which  it  is  frequently  combined. 

M.  M.  Inhaling  the  (team  of  warm  water,  evacuations,  warm 
bath,  afterwards  opium,  forbentia. 

9.  Exfiuiatio  pvie  aures.  A  difcharge  behind  the  ears.  This 
chiefly  affects  children,  and  is  a  morbid  fecretion  ;  as  appears 
from  its  fetcr  ;  for  if  it  was  owing  to  defect  of  abforption,  it 
would  be  faline,  and  not  fetid  ;  if  a  morbid  action  has  continued 
a  confiderable  time,  it  (hould  not  be  flopped  too  fuddenly  ;  fmce 
in  that  cafe  fome  other  morbid  action  is  liable  to  fucceed  in  its 
itead.  Thus  children  are  believed  to  have  had  colics,  or  even 
convulfions,  confequeBt  to  the  too  fudden  healing  of  thefe  mor- 
bid effufions  behind  their  ears.  The  rationale  of  this  is  to  be  ex- 
plained from  a  medical  facl,  which  I  have  frequently  obierved  ; 
and  that  is,  that  a  bliiler  on  the  back  greatly  ftrengthens  the 
power  ofdigeftion,  and  removes  the  heart-burn  in  adults,  and 
green  (lools  in  children.  The  ftimulus  of  the  blifter  produces 
ienfation  in  theveiTels  of  the  fkin  \  with  this  additional  fenfori- 
al  power  thefe  veflels  acl:  more  flrongly  \  and  with  thefe  the  vef- 
fels  of  the  internal  membranes  of  the  ftomach  and  bowels  ac~l 
with  greater  energy  from  their  direct  fympathy  with  them. 
Now  the  acrid  difcharge  behind  the  ears  of  children  produces 
fenfation  on  that  part  of  the  fkin,  and  fo  far  acts  as  a  fmall  blif- 
ter.  When  this  is  fuddenly  flopped,  a  debility  of  the  digeftive 
power  of  the  ftomach  fucceeds  from  the  want  of  this  accuilom- 
ed  ftimulus,  with  flatulency,  green  flools,  gripes,  and  fometimes 
confequent  convulfions.  See  Clafs  II.  i.  5.  6.  and  II.  i.  4.  6. 

M.  M.  If  the  matter  be  abforbed,  and  produce  fwelling  of  the 
lymphatics  of  the  neck,  it  mould  be  cured  as  foon  as  poffible  by 
dufting  the  part  with  white  lead,  cerufla,  in  very  fine  powder  ; 
and  to  prevent  any  ill  confequence  an  iffiie  {hould  be  kept  for 
about  a  month  in  the  arm  j  or  a  purgative  medicine  {hould  be 
taken  every  other  day  for  three  or  four  times,  which  mould  con- 
fift  of  a  grain  of  calomel,  and  three  or  four  grains  of  rhubarb, 
and  as  much  chalk.  If  there  be  no  appearance  of  abforption, 
it  is  better  only  to  keep  the  parts  clean  by  warning  them  with 
warm  water  morning  and  evening  ;  or  putting  fuller's  earth  on 
them  ;  eipecially  till  the  time  of  toothing  is  pail.  The  tinea,  or 
fcald  head,  and  a  leprous  eruption,  which  often  appears  behind 
the  ears,  are  different  difeafes. 

10.  GonorrKtiea  calida.  Warm  gleet.  Increafed  difcharge  of 
mucus  from  the  urethra  or  proftrate  gland  without  venereal  de- 
lire,  or  venereal  infection.  See  Clafs  I.  2.  3.  8. 

M.  M.   Camharidcs,  balfams,  rhubarb,  biifler  on  perineum, 

cold 


2. 1  DISEASES  CLASS  I.  r.  i.  iis 

cold  bath,  injections   of  metallic  falts,   flannel  fhirt,  change  of 
the  form  of  the  accuftosned  chair  or  faddle  of  the  patient. 

1 1.  Fluor  albus  calidus.     Warm  fluor  albus.     Increafed  fecre- 
tion  of  mucus  in  the  vagina  or  uterus  without  venereal  defire  of 
venereal  infection.     It  is  diftinguiihed  from  the  fiuor  albus  fn-T- 
idus  by  the   increafed  fenfe  of  warmth  in  the   part,  and  by  the 
greater  opacity  or  fpiffitude  of  the  material  difcharged  ;  as  the 
thinner  parts  are  re-abforbed  by  the  increafed  action  of  the  ab- 
ibrbents,  along  with  the  faliiie  part,  whence  no  fmarting  or  ex- 
coriation attends  it. 

M.  M.  Mitcilage,  as  ifinglafs,  hartfhorn  jelly,  gum  arabic. 
Ten  grains  of  rhubarb  every  night.  Calico  or  flannel  fhift,  Opi- 
um, balfams.  See  Clafsl.  2.  3.  7. 

12.  Htzmorrhois  alba.     White  piles.     An  increafed  difcharge 
of  mucus  from  the  rectum   frequently  miftaken  for   matter  ;  is 
faid  to   continue  a  few  weeks,  and  recur  like  the  bleeding  piles  5 
and  to  obey  lunar  influence.     See  Clafs  I.  2.  I.  6. 

M.  M.  Abflinence  from  vinous  fpirit.  Balfam  of  copaiva. 
Spice  fwallowed  in  large  fragments,  as  ten  or  fifteen  black  pep- 
per-corns cut  in  half,  and  taken  after  dinner  and  fupper.  Warci's 
pafte,  confiding  of  black  pepper  and  the  powdered  root  of  He-' 
lenium  Enula. 

13.  Serum  e  veficatoric.     Difcharge  from  a  blifler.     The  ex- 
cretory duels  of  glands  terminate  in  membranes,  and  are  endu- 
ed with  great  irritability,  and  many  of  them  with  fenfibility  ;  the 
latter  perhaps  in  confequence  of  their  facility  of  being  excitable 
into  great  action  ;  inftances  of  this  arc  the  terminations  of  th<;:' 
gall-duel:  in  the  duodenum,  and  of  the  falivary  and    lachrymal 
glands  in   the  mouth  and  eye  ;  which  produce  a  greater  fecre- 
tion  of  their  adapted  fluids,  when  the  ends  of  their  excretory 
duels  are  flimulated. 

The  external  fkin  confifts  of  the  excretory  duets  of  the  capil- 
laries, with  the  mouths  of  the  abforbents  ;  when  thefe  are  flim- 
ulated by  the  application  of  cantharides,  or  by  a  flice  of  the  frelh 
root  of  bryonia  alba  bound  on  it,  the  capillary  glands  pour  an 
increafed  quantity  of  fluid  upon  the  fkin  by  their  increafed  ac- 
tion ;  and  the  abforbent  veflels  imbibe  a  greater  quantity  of  the 
more  fluid  and  faline  part  of  it  j  whence  a  thick  mucous  or  fe- 
f-bus  fluid  is  depofited  between  the  ikin  and  cuticle. 

14.  Perfpiratio  foetida.     Fetid  perforation.     The  ufes  of  the 
perfpirable  matter  are  to  keep  the   fkin  foft  and  pliant,  for  the 
purpofes  of  its  eafier  flexibility  during  the  activity  of  our  limbs  iri 
locomotion,  and  for  the  prefervation  of  the  accuracy  of  the  fenfo 
of  touch,   which   is  difFufed  under    the  whole   furface   of  it  to 
guard    us  againfl  the  injuries  of  external  bodies;  in  the  fame 

manner 


CLASS!,  i.  2.  14.          OF  IRRIGATION.  25 

manner  as  the  fecretion  of  tears  is  defigned  to  preferve  the  cor- 
nea of  the  eye  moift,  and  in  confequence  transparent  ;  yet  has 
this  cutaneous  mucus  been  believed  by  many  to  be  an  excre- 
ment ;  and  I  know  not  how  many  fanciful  theories  have  been 
built  on  its  fuppofed  obftruction.  Such  as  the  origin  of  catarrhs, 
soughs,  inflammations,  eryfipelas,  and  herpes* 

To  all  thefe  it  may  be  fufficient  to  anfwer,  that  the  ancient 
Grecians  oiled  themfelves  all  over  ;  that  fome  nations  have 
painted  themfelves  all  over,  as  the  Pi6ts  of  this  ifland  ;  that  the 
Hottentots  fmear  themfelves  all  over  with  greafe.  And  laftly, 
that  many  of  our  own  heads  at  this  day  are  covered  with  the 
flour  of  wheat  and  the  fat  of  hogs,  according  to  the  tyranny  of  a 
filthy  and  wafteful  fafhion,  and  all  this  without  inconvenience. 
To  this  muft  be  added  the  ftricl:  analogy  between  the  ufe  of  the 
perfpirable  matter  and  the  mucous  fluids,  which  are  poured  for 
fimilar  purpofes  upon  all  the  internal  membranes  of  the  body  ; 
and  befides  its  being  in  its  natural  ftate  inodorous  ;  which  is 
not  fo  with  the  other  excretions  of  feces,  Or  of  urine. 

The  quantity  of  perfpirable  matter  being  greater  than  that  of 
the  excrementitious  matters  voided  by  ftool  and  urine,  has  been 
ufed  as  an  argument  in  favour  of  its  being  an  excrement ;  the  force 
of  which  I  de  not  fee  :  but  can  readily  underftand,  that  there 
muft  of  neceffity  be  a  great  exhalation  of  a  fluid  which  is  difFu- 
fed  over  the  whole  external  furface  of  the  warm  fkirt,  and  per- 
haps warmer  lungs,  for  the  purpofe  of  keeping  them  moift  and 
pliant,  and  which  is  perpetually  renewed  as  it  evaporates  ;  but, 
if  it  be  conceived  to  be  an  excrement,  there  feems  to  have  been 
no  neceffity  for  its  quantity  being  fo  great. 

The  evaporation  of  this  great  quantity  of  fluid,  fecreted  on  the 
farface  of  the  fkin  and  lungs,  muft  carry  off  much  heat  from 
the  body  ;  and  as  both  this  fecretion  and  confequent  evaporation 
will  be  in  proportion  to  the  aclivity  of  the  cutaneous  veflels,  and 
the  heat  occafioned  by  their  increafed  fecretion,  it  would  feem, 
that  this  evaporation  of  perfpirable  matter  is  the  caufe  which 
preferves  the  animal  body  at  the  uniform  degree  of  heat  of  98  ; 
in  the  fame  manner  as  the  evaporation  of  boiling  water  preferves 
it  at  2 1 2  degrees  of  Farenheit's  fcale. 

The  peculiar  ufe  of  the  perfpirable  matter  in  preferving  the 
membranes  moift,  which  line  the  air-pipes  of  the  lungs,  appears 
from  the  curious  difcovery  of  Dr.  Prieftley,  that  the  oxygen  of 
the  atmofphere  will  pafs  through  moift  animal  membranes,  but 
not  through  dry  ones,  fo  that  if  the  membranes  of  the  trachea 
were  to  become  dry,  the  animal  muft  as  immediately  perifh  as- 
if  he  was  to  breath  azotic  gas  alone.  See  Sect.  XXVITI.  2.  cf 
the  preceding  volume. 

VOL.  II.  E  la 


16  DISEASES  CLASS  1. 1.2.  14. 

In  fome  conftitutions  the  perfpirable  matter  of  the  lungs  ac- 
quires a  difagreeable  odour  ;  in  others  the  axilla,  and  in  others 
the  feet,  emit  difguilful  effluvia  ;  like  the  fecretions  of  thofe 
glands,  which  have  been  called  odoriferse  ;  as  thofe,  which  con- 
tain the.  caftor  in  the  beaver,  and  thofe  within  the  rectum  of 
dogs,  the  mucus  of  which  has  been  fuppofed  to  guard  them 
again f I  the  great  coftivenefs,  which  they  are  liable  to  in  hot 
fummers  ;  and  which  has  been  thought  to  occafion  canine  mad- 
nefs,  but  which,  like  their  white  excrement,  is  more  probably 
owing  to  the  deficient  fecretion  of  bile.  Whether  thefe  odorif- 
erous particles  attend  the  perfpirable  matter  in  confequence  of 
the  increafed  action  of  the  capillary  glands,  and  properly  be 
called  excrementitious  ;  that  is,  whether  any  thing  is  elimina- 
ted, which  could  be  hurtful  if  retained  ;  or  whether  they  may 
only  contain  fome  of  the  eflential  oil  of  the  animal ;  like  the 
fmdl,  which  adheres  to  one's  hand  on  {broking  the  hides  of 
fome  dogs  ;  or  like  the  effluvia,  which  is  left  upon  the  ground, 
from  the  feet  of  men  and  other  creatures  ;  and  is  perceptible  by 
the  nicer  organs  of  the  dogs,  which  hunt  them,  may  admit  of 
doubt. 

Add  to  this,  that  fome  parts  of  the  fkin  are  liable  to  more 
profufe  perfpiration  than  other  parts  without  poffeiling  any  fetid 
fcent,  as  the  {kin  of  the  face,  on  any  more  violent  exercife.  This 
feenis  to  have  been  obferved  very  early  in  the  hiftory  of  man- 
kind, as  it  was  faid,  that  our  firft  parents  mould  earn  their  bread 
by  the  fweat  of  their  brow.  Why  this  circumftance  does  not 
attend  other  animals  is  a  curious  inquiry.  Mankind  foon  learn- 
ed to  cover  their  bodies,  except  their  faces,  with  clothes  •,  when 
the  face,  by  being  more  frequently  expofed  to  greater  variations 
of  heat  and  cold,  acquired  greater  irritability,  or  fenfibility,  or 
afibciability,  and  thus  has  become  more  excitable  into  greater  ac- 
tion by  the  ftimulus  of  exercife,  or  by  that  of  food,  or  by  the  va- 
riolus  infection,  than  other  parts  of  the  fkin,  as  fpoken  of  m 
Ciafs  IV.  i.  2.  1 2-,  which  alfo  appears  by  its  fympathy  with 
difeafes  of  the  liver  or  ftomach  by  fenfitive  aiTociations,  as  in  the 
gutta  rofea.  From  all  thefe  analogous  facts  the  profufe  fweat, 
which  exudes  from  the  face  on  exercife,  does  not  appear  to  be 
an  excrementitious  fluid,  but  fimply  the  confequence  of  more 
violent  action  of  the  cutaneous  or  perfpirative  glands. 

M.  M.  Wafh  the  parts  twice  a  day  with  foap  and  water ; 
\vith  lime  water  ;  cover  the  feet  with  oiled  filk  locks,  which 
mult  be  waihed  night  and  morning.  Cover  them  with  charcoal 
recently  made  red  hot,  and  beaten  into  fine  powder  and  fifted, 
as  foon  as  cold,  and  kept  well  corked  in  a  bottle,  to  be  waflic-d 

off 


CLASS  I.  i.  2.  15.       OF  IRRITATION.  27 

off  and  renewed  twice  a  day.  Internally  rhubarb  grains  vi.  or 
viii.  every  night,  fo  as  to  procure  a  itool  or  two  extraordinary 
every  day,  and  thus  by  increafing  one  evacuation  to  decreafe  an- 
other. Cool  drefs,  diluting  liquids  ? 

15.  Crines  now.  New  hairs.  The  black  points  on  the  faces 
of  fome  people  confift  of  mucus,  which  is  become  vifcid,  aiul 
which  adheres  in  the  excretory  du£ts  of  the  glands  of  the  fkin  \ 
as  defcribed  in  Clafs  I.  2.  2.  9.  and  which  may  be  prefled  out 
by  the  fingers,  and  refernbles  little  worms.  Similar  to  this 
would  feem  the  fabrication  of  filk  and  of  cobweb,  by  the  filk- 
worm  and  fpider ;  which  is  a  fecreted  matter  prefled  through 
holes,  which  are  the  excretory  ducts  of  glands.  And  it  is  prob- 
able, that  the  production  of  hair  on  many  parts  of  the  body,  and 
at  different  periods  of  life,  may  be  effected  by  a  fimilar  procefs ; 
and  more  especially  as  every  hair  may  be  confidered  as  a  Header 
flexible  horn,  and  is  an  appendage  of  the  fkin.  See  Seer. 
XXXIX.  3.  2.  Now  as  there  is  a  fenfitive  fympathy  between 
the  glands,  which  fecrete  the  femen,  and  the  throat,  as  appears 
in  the  mumps  ;  fee  Hydrophobia,  Clafs  IV.  i.  2.  7.  and  Paroti- 
tis, Clafs  IV.  i.  2.  19.  the  growth  of  the  beard  at  puberty  feems 
to  be  caufed  by  the  greater  action  of  the  cutaneous  glands  about 
the  chin  and  pubes  in  confequence  of  their  fympathy  with  thofe 
of  the  teftes.  But  this  does  not  occur  to  the  female  fex  at  their 
time  of  puberty,  becaufe  the  fenfitive  fympathy  in  them  feems. to 
exift  between  the  fubmaxillary  glands,  and  the  pectoral  ones  ; 
which  fecrete  the  milk,  and  afford  pleafure  both  by  that  fecre- 
tion,  and  by  the  erection  of  the  mammilla?,  or  nipples  ;  and 
by  delivering  the  milk  into  the  mouth  of  the  child  ;  this  fen- 
fitive fympathy  of  the  pectoral  and  fubmaxillary  glands  in 
women  is  alfo  obfervable  in  the  Parotitis,  or  mumps,  as  above 
referred  to. 

When  hairs  grow  on  the  face  or  arms  fo  as  to  be  difagreea- 
ble,  they  may  be  thus  readily  removed  without  pain  or  any  ill 
confequence.  Warm  the  ends  of  a  pair  of  nippers  or  forceps, 
and  ftick  on  them  a  little  refin,  or  burgundy  pitch  ;  by 
thefe  means  each  fmgle  hair  may  be  taken  fafi  hold  of  ;  and 
if  it  be  then  plucked  off  flowly,  it  gives  pain  ;  but  if  plucked 
off  fuddenly,  it  gives  no  pain  at  all  ;  becaufe  the  vis  inertia 
of  the  part  of  the  fkin,  to  which  it  adheres,  is  not  overcome ; 
and  it  is  not  in  confequence  feparated  from  the  cellular  mem- 
brane under  it.  Some  of  the  hairs  may  return,  which  are 
thus  plucked  off,  or  others  may  be  induced  to  grow  near  them  , 
but  in  a  little  time  they  may  be  thus  fafely  deftroyed  ;  which 
is  much  to  be  preferred  to  the  methods  faid  to  be  ufed  in  Turkey 


28  DISEASES  CLASS  I.  i.  2.  15. 

to  eradicate  hair  5  fuch  as  a  mixture  of  orpiment  and  quick 
lime  ;  or  of  liver  of  fulphur  in  folution  •,  which  injure  the  fkin, 
if  they  are  not  very  nicely  managed  ;  and  the  hair  is  liable  to 
grow  again  as  after  (having  ;  or  to  become  white,  if  the  roots 
of  it  have  been  much  inflamed  by  the  caufticity  of  the  applica- 
tion. See  Clafs  I.  2.  2.  i.i.  on  grey  hairs. 


pRDO 


CLASS  I.  i.  3.  i.          OF  IRRITATION,  29 

ORDO  I. 

Increafed  Irrit 

GENUS  Hf. 
With  increafed  AElions  of  the  Alforbent  Syjlem. 

THESE  are  not  attended  with  fo  great  increafe  of  heat  as  in  the 
former  genus,  becaufe  the  fluids  probably  undergo  lefs  chemical 
change  in  the  glands  of  the  abforbent  fyftern  j  nor  are  the  glands 
of  the  abforbent  vefiels  fo  numerous  or  fo  extenfive  as  thole  of 
the  fecerning  ones.  Yet  that  fome  heat  is  produced  by  the  in- 
creafed aftion  of  the  abforbents  appears  from  the  greater  gener- 
al warmth  of  the  {kin  and  extremities  of  feeble  patients  after  the 
exhibition  of  the  peruvian  bark,  and  other  medicines  of  the  arti- 
cle Sorbentia. 

SPECIES. 

I.  Lingua  arida.  Dry  tongue  occurs  in  thofe  fevers,  where 
the  expired  air  is  warmer  than  natural ;  and  happens  to  all  thofe, 
•who  fleep  with  their  mouths  open  ;  the  currents  of  air  in  refpi- 
ration  increafmg  the  evaporation.  There  is  alfo  a  drynefs  in 
the  mouth  from  the  increafed  action  of  the  abforbent  veflels, 
when  a  floe  or  a  crab-apple  is  mafticated  ;  and  after  the  perfpi. 
ration  has  been  much  increafed  by  eating  fait  or  fpice,  or  after 
other  copious  fecretions  j  as  after  drunkennefs,  cathartics,  or 
fever  fits,  the  mucus  of  the  mouth  becomes  vifcid,  and  in  fmall 
quantity,  from  the  increafed  abforption,  adhering  to  the  tongue 
like  a  white  flough.  In  the  diabetes,  where  the  thirft  is  very 
great,  this  flough  adheres  more  pertinucioufly,  and  becomes  black 
or  brown,  being  coloured  after  a  few  days  by  our  aliment  or 
drink.  The  iiifpiflated  mucus  on  the  tongue  of  thofe,  who  fleep 
with  their  mouths  open,  is  fometimes  reddened  as  if  mixed  with 
blood,  and  fometimes  a  little  blood  follows  the  expuition  of  it 
from  the  fauces  owing  to  its  great  adhefion.  When  this  mucus 
adheres  long  to  the  papillae  of  the  tongue,  the  faliva,  which  it 
contains  in  its  interilices,  like  a  fponge,  is  liable  to  become  pu- 
trid, and  to  acquire  a  bitter  tafte,  like  other  putrid  animal  fub- 
ftances ;  which  is  generally  miilaken  for  an  indication  of  the 
prefence  of  bile. 

M.  M.  Warm  fubacid  liquids.     See  Clafs  I.  2.  5.  8. 

A-.  Fattcfs  aridx*  Dry  throat.  The  expuition  of  a  frothy 

mucus 


30  DISEASES  CLASS  I.  i.  3.  3. 

mucus  with  great  and  perpetual  hawking  occurs  in  hydrophobia, 
and  is  very  diftreffing  to  the  patient  ;  which  may  be  owing  to 
the  increafed  irritability  or  fenfibility  of  the  upper  part  of  the 
cefophagus,  which  will  not  permit  any  fluid  to  reft  on  it. 

It  affects  fome  people  after  intoxication,  when  the  lungs  re- 
main flightly  inflamed,  and  by  the  greater  heat  of  the  air  in  ex- 
piration the  mucus  becomes  too  haliily  evaporated,  and  is  expec- 
torated with  difficulty  in  the  ftate  of  white  froth. 

I  knew  a  perfoa,  who  for  twenty  years  always  waked  with  his 
tongue  and  throat  quite  dry ;  fo  that  he  was  neceflitated  to  take 
a  fpoonful  of  water,  as  foon  as  he  awoke  ;  otherwife  a  little  blood 
always  followed  the  forcible  expuition  of  the  indurated  mucus 
from  his  fauces.  See  Clafs  II.  1.3.  17. 

M.  M.  Steel-fprings  fixed  to  the  night-cap  fo  as  to  fufpend  the 
lower  jaw  and  keep  it  clofed  ;  or  fprings  of  elaftic  gum.  Or  a 
pot  of  water  fufpended  over  the  bed,  with  a  piece  of  lift,  or 
woollen  cloth,  depending  from  it,  and  held  in  the  mouth  ;  which 
will  act  like  a  fyphon,  and  flowly  fupply  moifture,  or  barley  wa- 
ter fhould  be  frequently  fyringed  into  the  mouth  of  the  patient. 

3.  Nares  aridi.     Dry  noftrils  with  the  mucus  hardening  up- 
on their    internal   furface,  fo  as  to  cover  them    with  a  kind  of 
ikin  or  fcale,  owing  to  the  increafed  action  of  the  abforbents  of 
this  membrane  ;  or  to  the  too  great  drynefs  of  the  air,  which 
paiTes  into  the  lungs  j  or  too  great  heat  of  it  in  its  expiration. 

When  air  is  fo  dry  as  to  lofe  its  tranfparency  -,  as  when  a  trem- 
ulous motion  of  it  can  be  feen  over  corn-fields  in  a  hot  fummer's 
day  ;  or  when  a  dry  mift,  or  want  of  tranfparency  of  the  air,  is 
vifible  in  very  hot  weather  \  the  fenfe  of  fmell  is  at  the  fame 
time  imperfect  from  the  drynefs  of  the  membrane,  beneath  which 
it  is  fpread. 

4.  Expefioratio  fotida.      Solid   expectoration.     The  mucus 
of  the  lungs  becomes  hardened  by  the  increafed  abforption,  fo 
that  it  adheres  and  forms  a  kind  of  lining  in  the  air-cells,  and  is 
fometimes  ipit  up   in  the  form  of  branching  vefTels,  which  are 
called  polypi  of  the  lungs.     See  Tranfact.  of  the  College,  Lon- 
don.    There  is  a  rattling  or  wheezing  of  the  breath,  but  it  is 
not  at  firft  attended  with  inflammation. 

The  Cynanche  trachealis,  or  Croup,  of  Dr.  Cullen,  or  Angina 
polypofa  of  Michaelis,  if  they  differ  from  the  peripneumony  of  in- 
fants, feem  to  belong  to  this  genus.  When  the  difficulty  of  ref- 
piration  is  great,  venefection  is  immediately  neceffary,  and  then 
an  emetic,  and  a  blifter.  And  the  child  fhould  be  kept  nearly 
upright  in  bed  as  much  as  may  be.  See  Tonfillitis,  Clafs  II.  I. 
3.  3.  and  II.  I.  2.  4. 

M.  M.  Diluents,  emetics,  efTence  of  antimony,  foetid  gums, 

onions, 


CLASS  I.  i.  3.  $.        OF  IRRITATION.  3 1 

onions,  warm  bath  for  half  an  hour  every  day  for  a  month.     In- 
haling the  fteam  of  water,  with  or  without  volatile  alkali.     Soap. 

5.  Cotiftipatio  al-vi.     Coltivenefs  from  increafed  action  of  the 
inteftinal  abforbents.     The  feces  are  hardened  in  lumps  called 
fcybala  ;  which  are  fometimes  obliged  to  be  extracted  from  the 
rectum  with  a  kind  of  marrow  fpoon.     This  is  faid  to  have  hap- 
pened from  the  patient  having  taken  much  ruft  of  iron.     The 
mucus  is  alfo  hardened  fo  as  to  line  the  interlines,  and  to  come 
away  in  fkins,  rolled  up  as  they  pafs  along,  fo  as   to  refemble 
worms,  for  which  they  are  frequently  miftaken  ;  and  fometimes 
it  is  evacuated  in  itill  larger  pieces,  fo  as  to  counterfeit  the  form 
of  the  inteftines,  and  has  been  miftaken  for  a  portion  of  them. 
Balls  of  this  kind,  nearly  as  heavy  as  marble,  and  confiderably 
hard,  from  two  inches  to  five  in  diameter,  are  frequently  found  in 
the  bowels  of  horfes.     Similar  balls  found  in  goats  have  been 
called  Bezoar. 

M.  M.  Cathartics.  Diluents,  fruit,  oil,  foap,  fulphur,  warm. 
bath.  Sprinkling  with  cold  water,  cool  clothing.  See  Clafs  I. 
2.  4.  18. 

6.  Cutls  arida.    Dry  fkin.     This  dry  fkin  is  not  attended  with 
coldnefs  as  in  the  beginning  of  fever-fits.     Where  this  cutaneous 
abforption  is  great,  and  the  fecreted  material  upon  it  vifcid,  as 
on  the  hairy  fcalp,  the  fkin  becomes  covered  with  hardened  mu- 
cus ;  which  adheres  fo  as  not  to  be  eafily  removed,  as  the  fcurf 
on  the  head ;  but  is  not  attended  with  inflammation  like  the 
Tinea,  or  Lepra.     The  moifture,  which  appears  on  the  fkin  be- 
neath refmous  or  oily  platters,  or  which  is  feen  to  adhere  to  fuch 
plafters,  is  owing  to  their  preventing  the  exhalation  of  the   per- 
fpirable  matter,  and  not  to  their  increafing  the  production  of  it, 
as  fome  have  idly  imagined. 

M.  M.  Warm  bathing,  oil  externally,  oil-fkin  gloves,  refm- 
ous plafters.  Wax. 

7.  Urina  parca  colorata.  Diminiihed  urine,  which  is  high  col- 
oured, and  depofits  an  earthy  fediment,  when  coM,  is  owing  to 
the  great  action  of  the  urinary  abforbents.  See  Clafs  I.  i.  2. 
4.  In  fome  dropfies  the  cutaneous  abforbents  are  paralytic,  as 
well  as  thofe  opening  into  the  cellular  membrane ;  and  hence, 
no  moifture  being  acquired  from  the  atmofphere,  or  from  the 
cellular  membrane,  great  thirft  is  excited  -9  and  great  abforption 
from  all  parts,  where  the  abforbents  are  (till  capable  of  a6tion. 
Hence  the  urine  is  in  very  fmall  quantity,  and  of  deep  colour, 
with  copious  fediment ;  and  the  kidneys  are  erroneoufly  blamed 
for  not  doing  their  office  ;  itimulant  diuretic  medicines  aregiv-. 
en  in  vain  ;  and  very  frequently  the  unhappy  patient  is  reftrain- 
e-d  from  quenching  his  thirft,  and  dies  a  martyr  to  falfe  theory. 

M.  M.  Diluent 


32  DISEASES  CLASS  I.  1.3.  g. 

M.  M.  Diluent  liquids,  and  warm  bathing,  are  the  natural 
cure  of  this  fymptom  ;  but  it  generally  attends  thofe  dropfies,- 
which  are  feldom  curable  ;  as  they  are  owing  to  a  paralyfis  both 
of  the  cutaneous  and  cellular  lymphatics. 

8.  Calculus  felleus.     Gall-done.     From  the  too  hafty  abforp- 
tion  of  the  thinner  parts  of  the  bile,  the  remainder  is  left  too 
vifcid,  and  cryftallizes  into  lumps ;    which,  if  too  large  to  pafs, 
obftracl  the  du&us  choledochus,  producing  pain  at  the  pit  of 
the  ftomach,  and  jaundice.     When  the  indurated  bile  is   not 
harder  than  a  boiled  pea,  it  may  pafs  through  the  bile-du£t  with 
difficulty    by   changing    its   form ;  and  thus  gives  thofe  pains, 
•which  have  been  called  fpafms  of  the   ftomach   ;   and  yet  thefe 
vifcid  lumps  of  bile  may  afterwards  dirTolve,  and  not  be  vifible 
among  the  feces. 

In  two  inftances  I  have  feeii  from  thirty  to  fifty  gall-ftones 
voided  after  taking  an  oil  vomit  as  below.  They  were  about 
the  fize  of  peas,  and  diftinguifhable  when  dry  by  their  being  in- 
flammable like  bad  wax,  when  put  into  the  flame  of  a  candle* 
For  other  caufes  of  jaundice,  fee  Clafs  I.  2.  4.  19. 

M.  M.  Diluents,  daily  warm  bathing.  Ether  mixed  with 
yolk  of  egg  and  water.  Unboiled  acrid  vegetables,  as  lettuce, 
cabbage,  muftard,  and  crefies.  When  in  violent  pain,  four 
ounces  of  oil  of  olives,  or  of  almonds,  ihould  be  fwallowed  ;  and 
as  much  more  in  a  quarter  of  an  hour,  whether  it  itays  or  not. 
The  patient  Ihould  lie  on  the  circumference  of  a  large  barrel, 
firit  on  one  fide,  and  then  on  the  other.  Electric  (hocks  through 
the  gall-duel.  Factitious  Seltzer  water  made  by  dilTolving  one 
dram  of  fal  foda  in  a  pint  of  water ;  to  half  a  pint  of  which  made 
luke-warm  add  ten  drops  of  marine  acid  ;  to  be  drunk  as  foon 
as  mixed,  twice  a  day  for  fome  months.  Opium  muft  be  ufed 
to  quiet  the  pain,  if  the  oil  does  not  fucceed,  as  two  grains,  and 
another  grain  in  half  an  hour  if  neceflary.  See  Clafs  IV.  2.  2. 4. 

9.  Calculus  rents.     Stone  of  the  kidney.     The  pain  in  the  loins 
and  along  the  courfe  of  the  ureter  from  a  flone  is  attended  with 
retraction  of  the  tefticle  in  men,  and  numbnefs  on  the  infide  of 
the  thigh  in  women.     It  is  diftinguiflied   from  the  lumbago  or 
fciatica,  as  thefe  latter   are  feldoiri   attended  with  vomiting,  and 
have  pain  on  the  outfide  of  the  thigh,  fometimes  quite  down  to 
the  ancle  or  heel.     See  Herpes  and  Nephritis. 

Where  the  abforption  of  the  thinner  parts  of  the  fecretion 
takes  place  too  haftily  in  the  kidneys,  the  hardened  mucus,  and 
confequent  calculous  concretions,  fometimes  totally  flop  up  the 
tubuli  uriniferi,  and  no  urine  is  fecreted.  Of  this  many  die, 
who  have  drunk  much  vinous  fpirit,  and  fome  of  them  recover 
by  voiding  a  quantity  of  whit?  mucus,  like  chalk  and  water ;  and 


CLASS  I.  i.  3.  9.       OF  IRRITATION.  33 

others  by  voiding  a  great  quantity  of  fond,  or  fmall  calculi.  This 
ned  mucus  frequently  becomes  the  nucleus  of  a  ftone  in  the 
bladder.  The  falts  of  the  urine,  called  microcofmic  fait,  are  of- 
ten iniftaken  for  gravel,  but  are  diftinguifhable  both  by  their  an- 
gles of  cryftallization,  their  adhefion  to  the  fides  or  bottom  of 
the  pot,  and  by  their  not  beingformedtill  the  urine  cools.  Where- 
as the  particles  of  gravel  are  generally  without  angles,  and  always 
drop  to  the  bottom  of  the  veflel,  immediately  as  the  water  is 
voided. 

Though  the  proximate  caufe  of  the  formation  of  the  calculoua 
concretions  of  the  kidneys,  and  of  chalk-ftones  in  the  gout,  and 
of  the  infoluble  concretions  of  coagulable  lymph,  which  are  found 
on  membranes,  which  have  been  inflamed  in  peripneumony,  or 
rheumatifm,  confifts  in  the  two  great  action  of  the  abforbent 
veffels  of  thofe  parts  ;  yet  the  remote  caufe  in  thefe  cuies  is 
probably  owing  to  the  inflammation  of  the  membranes  ;  which 
at  that  time  are  believed  to  fecrete  a  material  more  liable  to  co- 
agulate or  concrete,  than  they  would  otherwife  produce  by  in- 
creafed  action  alone  without  the  production  of  new  veflels,which 
conftitutes  inflammation.  As  defined  in  Glafs  II.  I.  2. 

The  fluids  fecreted  from  the  mucous  membranes  of  animals 
are  of  various  kinds  and  confiftencies*  Hair,  filk,  fcales,  horns, 
finger-nails,  are  owing  to  natural  proceflfes.  Gall -ftones,  ftones 
found  in  the  interlines  of  horfes,  fcurf  of  the  {kin  iii  leprofy, 
ftones  of  the  kidneys  and  bladder,  the  callus  from  the  inflamed 
periofteum,  which  unites  broken  bones,  the  calcareous  cement,- 
which  repairs  the  injured  (hells  of  fnails,  the  calcareous  cruft  on 
the  eggs  of  birds,  the  annually  renewed  melts  of  crabs,  are  all  in- 
ilances  of  productions  from  mucous  membranes,  afterwards  in- 
durated by  abforptioxi  of  their  thinner  parts. 

All  thefe  concretions  contain  phofphoric  acid,  mucus,  and 
calcareous  earth  in  different  proportions  ;  and  are  probably  fo 
far  analogous  in  refpect  to  their  component  parts  as  well  as  their 
mode  of  formation.  Some  calcareous  earth  has  been  difcovered 
after  putrefaction  in  the  coagulable  lymph  of  animals.  Fordyce's 
Elements  of  Practice.  A  little  calcareous  earth  was  detected 
by  Scheele  or  Bergman  in  the  calculus  of  the  bladder  with  much 
phofphoric  acid,  and  a  great  quantity  of  phofphoric  acid  is  fhewn 
to  exift  in  oyfter-fhells  by  their  becoming  luminous  on  expofmg 
them  a  while  to  the  fun's  light  after  calcination  ;  as  in  the  ex- 
periments of  Wilfon.  Botanic  Garden,  P.  i.  Canto  i.  1.  182, 
note.  The  exchange  of  which  phofphoric  acid  for  carbonic  acid,- 
or  fixed  air,  converts  (hells  into  lime-ftone,  producing  mountains 
of  marble,  or  calcareous  ftrata. 

Now  as  the  hard  lumps  of  calcareous   matter,  termed  crabs' 
Vol.  II.  F  eyes, 


34  DISEASES  CLASS  I.  i.  3,  9; 

eyes,  which  are  found  in  the  ftomachs  of  thofe  animals  previous 
to  the  annual  renewal  of  their  (hells,  are  rediffolved,  probably 
by  their  gaftric  acid,  and  again  depofited  for  that  purpofe  ;  may 
it  not  be  concluded,  that  the  (tone  of  the  bladder  might  be  dif- 
folved  by  the  gaftric  juice  of  filh  of  prey,  as  of  crabs,  or  pike  •,  or 
of  voracious  young  birds,  as  young  rooks  or  hawks,  or  even  of 
calves  ?  Could  not  thefe  experiments  be  tried  by  collecting  the 
gaftric  juice  by  putting  bits  of  fponge  down  the  throats  of  young 
crows,  and  retracting  them  by  a  firing  in  the  manner  of  Spal- 
lanzani  ?  or  putting  pieces  of  calculus  down  the  throat  of  a  liv- 
ing crow,  or  pike,  and  obferving  if  they  become  digefled  ?  and 
lailly,  could  not  gaftric  juice,  if  it  fhould  appear  to  be  a  folvent, 
be  inje&ed  and  borne  in  the  bladder  without  injury  by  means  of 
catheters  of  claftic  refin,  or  caoutchouc  ? 

M.  M.  Diluents.  Cool  drefs.  Frequent  change  of  pofture. 
Frequent  horizontal  reft  in  the  day.  Bathe  the  loins  every  morn- 
ing with  a  fponge  and  cold  water.  Aerated  alkaline  water  in- 
ternally. Abftinence  from  all  fermented  or  fpirituous  liquors. 
Whatever  increafes  perfpiration  injures  thefe  patients,  as  it  dif- 
fipates  the  aqueous  particles,  which  ought  to  dilute  the  urine. 
When  the  conftitution  begins  to  produce  gravel,  it  may  I  believe 
be  certainly  prevented  by  a  total  abftinence  from  fermented  or 
fpirituous  liquors  ;  by  drinking  much  aqueous  fluids  ;  as  toaft 
and  water,  tea,  milk  and  water,  lemonade  -,  and  laftly  by  thin 
clothing,  and  fleeping  on  a  hardifh  bed,  that  the  patient  may  not 
lie  too  long  on  one  fide.  See  CJafs  IV.  2.  2.-  2.  There  is  reafon 
to  believe,  that  the  daily  ufe  of  opium  contributes  to  produce 
gravel  in  the  kidneys  by  increafing  abforption,  when  they  are 
inflamed  •,  in  the  fame  manner  as  is  done  by  fermented  or  fph> 
ituous  liquor.  See  Clafs  I.  3.  2.  n. 

When  the  kidneys  are  io  obftructed  with  gravel,  that  no  urine 
paflfes  into  the  bladder  ;  which  is  knov/n  by  the  external  appear- 
ance of  the  lower  part  of  the  abdomen,  which,  when  the  bladder 
i:>  full,  feems  as  if  contracted  by  a  cord  between  the  navel  and 
the  bladder  •,  and  by  the  tenfion  on  the  region  of  the  bladder 
diftinguiihableby  the  touch  ;  or  by  the  introduction  of  the  ca- 
theter 5  the  following  methods  of  cure  are  frequently  fuccefsfuL 
Vene  feel  ion  to  fix  or  eight  ounces,  ten  grains  of  calomel,  and 
an  infufion  of  fenna  with  falts  and  oil,  every  three  hours,  till 
ilools  are  procured.  Then  an  emetic.  After  the  patient  has 
been  thus  evacuated,  a  blifter  on  the  loins  fnonld  be  ufed  ;  and 
from  ten  to  twenty  eleclric  fhocks  fhould  be  paffed  through  the 
kidneys,  as  large  as  can  be  eafily  borne,  once  or  twice  a  day. 
Along  with  this  method  the  warm  bath  fhould  be  ufed  for  an 
hour  once  or  twice  a  day.  After  repeated  evacuations  a  clyfter, 

confifting 


CLASS  I.  i.  3.  10.    OF  IRRITATION.  35 

confifting  of  two  drams  of  turpentine  diflblved  by  yolk  of  egg, 
and  fixty  drops  of  tincture  of  opium,  mould   be  uied  at  n: 
and   repeated,  with  cathartic  medicines  interpofed,  every  ni 
or  alternate  nights.     Aerated  folution  of  alkali    fh;  '.iken 

..rally,  and  balfam  of  .copaiva,  three  or  four  times  a  day. 
Sonic  of  thefe  patients  recover  after  having  made  no  water  for 
jiine  or  ten  days. 

If  a  ftone  (licks  in  the  ureter  with  incefiant  vomiting  ten  gr 
of  calomel  mult  be  given  in  fmall  pills  as  above  ;  and  feme  b 
afterwards  infufion  of  fenna  and  ialts  and  oil,  if  it  can  b?  made 
to  itay  on  the  (loinadi.     And  after  :  has  operated  four 

.or  five  times,  an  opiate  is  to  be  given,  if  the  pain  continues,  con- 
fiiling  of  two  grains  of  opium.     If  this  does  not  fucceed,  tf. 
twenty  electric  (hocks  through  the  kidney  fhould  be  tried,  and 
the  purgative  repeated,  and  afterwards  the  opiate.     The  patient 
ihoiild  be  frequently  put  into  the  warm  bath  for  an  hour  at   a 
time.     Eighty  or  a  hundred  dfops  of  laudanum  given  in  a  .. 
ter,    with  two  drams  of  turpentine,  are  to  be  preferred  to  the 
two  grains  given  by  the  flomach  as  abovej  when  the  pain  and 
vomiting  are  very  urgent. 

jo.  Calculus  veficz.  Stone  of  the  bladder.  The  nucleus,  or 
kernel,  of  thefe  concretions  is  always  formed  in  the  kidney,  as 
above  defcribed ;  and  paflin^  clown  the  ureter  into  the  bladder, 
is  there  perpetually  increaled  by  the  mucus  and  falts  fecreted 
from  the  arterial  fyftem,  or  by  the  mucus  of  the  bladder,  difpo- 
fed  in  concentric  ftrata.  The  (lories  found  in  the  bowels  of 
liorfes  are  alfo  formed  on  a  nucleus,  and  coniiil  of  conce. 
fpheres  ;  as  appears  in  fawing  them  through  the  middle.  Bi^t 
as  thefe  are  formed  by  the  indurated  mucus  of  the  in.teftines 
alone  without  the  urinary  falts,  it  is  probable  a  difference  \yould 
be  found  on  their  analyfis. 

As  the  (tones  of  the  bladder  are  of  various  degrees  of  hardnefs, 
and  probably  differ  from  each  other  in  the  proportions  at  lead  of 
their  component  parts  ;  when  a  patient,  who  labours  under  this 
afflicling  difeafe,  voids  any  fmall  bits  of  gravel  ;  thefe  mould  be 
kept  in  warm  folutions  of  caudle  alkali,  or  of  mild  alkali  well 
aerated  ;  and  if  they  diffolve  in  thefe  folutions,  it  would  afford 
greater  hopes,  that  that  which  remains  in  the  bladder,  might  be 
affected  by  thefe  medicines  taken  by  the  (lomach,  or  inj' 
into  the  bladder. 

To  prevent  the  increafe  of  a  ftone  in  th*  bladder  much  diluent 
drink  (hould  be  taken  ;  as  half  a  pint  of  water  warmed  to  about 
eighty  degrees,  three  or  four  times  a  day  :  which  will  r;.ct  only 
prevent  the  growth  of  it,  by  preventing  any  mi .  :  falts 

from  being  precipitated  from  the  urine,  and  by  keeping  the  mu- 

CUi 


$6  DISEASES  CLASS!,  r.  3.  10. 

cus  fufpended  in  it ;  but  will  alfo  diminim  the  ftone  already 
formed,  by  foftening,  and  warning  away  its  furface.  To  this 
muft  be  added  cool  drefs,  and  cool  bed-clothes,  as  directed  above 
in  the  calculus  renis. 

When  the  ftone  is  puflied  againft  or  into  the  neck  of  the  blad- 
der, great  pain  is  produced  ;  this  may  fometimes  be  relieved  by 
the  introduction  of  a  bougie  to  pufh  the  ftone  back  into  the  fun-r 
dus  of  the  bladder.  Sometimes  by  change  of  pofture,  or  by  an 
opiate  either  taken  into  the  ftomach,  or  by  a  clyfter. 

A  dram  offal  foda,  or  of  fait  of  tartar,  dillblved  in  a  pint  of  wa- 
ter, and  well  faturated  with  carbonic  acid  (fixed  air),  by  means 
of  Dr.  Nooth's  glafs  apparatus,  and  drunk  every  day,  or  twice  a 
day,  is  the  moft  efficacious  internal  medicine  yet  difcovered, 
which  can  be  eafily  taken  without  any  general  injury  to  the  con- 
ftitution.  An  aerated  alkaline  water  of  this  kind  is  fold  under 
the  name  of  factitious  Seltzer  water,  by  J.  Schweppe,  at  No.  8, 
King's-ftreet,  Holborn,  London  ;  which  I  am  told  is  better  pre- 
pared than  can  be  eafily  done  in  the  ufual  glafs-veflels,  probabljr 
by  employing  a  greater  preflure  in  wooden  ones. 

A  curious  account  is  given  in  a  letter  to  Sir  John  Sinclair  from 
Colonel  Martin  5  who  afTerts,  that,  after  ufing  bougies  and  in- 
fections into  the  bladder,  the  paflage  of  the  urethra  became  left 
fenfible  to  pain,  and  he  was  enabled  to  introduce  fmall  files  (I 
fuppofe,  with  their  backs  fmooth)  j  and  that  by  thefe  he  gradu- 
ally filed  away  the  ftone,  as  it  lay  in  the  neck  of  the  bladder. 
When  the  ftone  did  not  properly  prefent  itfelf,  he  introduced 
warm  water  by  injection  into  the  bladder,  and  thus,  by  again,  en- 
deavouring to  difcharge  it,  brought  forward  the  ftone  to  the  neck 
of  it.  He  ufed  the  file  three  times  in  twenty-four  hours  from 
April  till  October.  Medical  Journal,  No,  II.  p.  121.  If  this 
procefs  mould  be  again  attempted,  perhaps  the  file  might  be  intro- 
duced through  a  flexible  canula,  with  a  metallic  hood  at  the  in- 
ternal end  of  the  canula  to  cover  the  back  of  the  file,  fo  as  to 
prevent  the  friction  of  it  againft  the  urethra,  or  neck  of  the  blad- 
der. If  the  urethra,  by  frequent  trials,  fhould  become  fp  infen- 
fible  as  to  admit  eafily  the  frequent  introduction  of  a  metallic 
canula,  might  not  two  fine  fteel  wires  properly  tempered  be  join- 
ed at  one  end  by  a  hinge",  and  thus  introduced  through  the  can- 
ula into  the  bladder  ;  and  when  protruded  beyond  the  extremity 
of  the  canula,  they  might  open  by  their  elafticity  fo  as  to  receive 
the  ftone,  and  confine  it  againft  the  end  of  the  canula,  by  re- 
tracting them  ?  The  proper  direction  of  the  wire-fprings,  fo  as 
to  open  when  they  are  pufhed  through  the  canula,  muft  be  pre- 
vioufly  given  them.  If  this  could  be  managed,  a  fmall  file  or 
borer  might  at  the  fame  time  be  introduced  through  the  canula, 

the 


a  ASS  I.  i.  3-  1 1         OF  IRRITATION.  37 

the  handles  of  which  might  confift  of  joints  to  permit" them  to 
i   in  all  directions,  and  thus  the  11  one  might  be  broken  to 
• ;  by  a  few  trials ;  or  if  it  was  a  loft  or  fragile  ftone,  the  re- 
traclion  of  the  wire -bow  might  divide  it  at  every  trial,  till  it  be- 
almoft  reduced  to  powder.     A  little  mechanical  ingenuity 
might  be  neceflary  in  rhe  conftrufrJon  and  ufeof  this  machine- 
ry ;  but  I  believe  it  not  to  be  impracticable,  fince  I  read  the  above 
account  of  Colonel  Martin,  though  I  had  often  before  thought 
of  it  with  defpair  of  its  fuccefsful  application. 

Lithotomy  is  the  lail  refource.  Will  the  gaftric  juice  of  ani- 
mals diflblve  calculi?  Will  fermenting  vegetable  juices*  as 
fweet-wort,  or  fugar  and  water  in  the  a£l  of  fermentation  with 
yeaft,  diflblve  any  kind  of  animal  concretions  ? 

1 1 .  Calculus  artlriticus.     Gout-ftones  are  formed  on  infla- 
med membranes,  like  thofe  of  the  kidneys  above  defcribed,  by  the 
too  hafty  abforption  of  the  thinner  and  faline  parts  of  the  mucus. 
Similar  concretions  have  been  produced  in  the  lungs,  and  even 
in  the  pericardium  ;  and  it  is  probable,  that  the  omfication,  as  it 
15  called,  of  the  minute  arteries,  which  is  faid  to  attend  old  age, 
arul  to  precede  fome  mortifications  of  the  extremities,  may  be  a 
procefs  of  this  kind. 

As  gout-ftones  lie  near  the  furface,  it  is  probable,  that  ether, 
frequently  applied  in  their  early  ftate,  might  render  them  fo  li- 
quid as  to  permit  their  re-abforption  ;  which  the  ilimulus  of  the 
ether  might  at  the  fame  time  e  ncourage. 

12.  Rheumatifmus  cbronicus.    Chronic  rheumatifm.    After  the 
acute  rheumatifm  fome  mfpifTated  mucus,  or  material  fimilar  to 
chalk-ftones  of   the  gout,  which  was  fecreted  on  the  inflamed 
membrane,  is  probably  left,  owing  to  the  too  hafty  abforption  of 
the  thinner  and  faline  part  of  it ;  and  by  lying  on  the  fafcia,  which 
covers  fome  of  the  mufcles,  pains  them,  when  they  move  and  rub 
againil  it,  like  any  extraneous  material. 

The  pain  of  the  fhoulder,  which  attends  inflammations  of  the 
upper  membrane  of  the  liver,  and  the  pains  of  the  arms,  which 
attend  afthma  dolorificurn,  or  dropfy  of  the  pericardium,  are  dif- 
tinguifhed  from  the  chronic  rheumatifm,  as  in  the  latter  the  pain 
only  occurs  on  moving  the  affected  mufcles. 

M.  M.  Warm  bath,  cold  bath,  bandage  of  emplaftrum  de 
minio  put  on  tight,  fo  as  to  comprefs  the  part.  Cover  the  part 
with  flannel.  With  oiled  (ilk.  Rub  it  with  common  oil  fre- 
quently. With  ether.  A  blifter.  A  warmer  climate.  Ven- 
efection.  A  grain  of  calomel  and  a  grain  of  opium  for  ten  fuc- 
ceflive  nights..  The  Peruvian  bark. 

13.  Clcatrix  vulnsrum.     The  fear  after  wounds.     In  the  heal- 
uf   ulcers  the    matter  is  firit  thickened  by  increafmg  the 

abforption 


3$  DISEASES          CLASS  I.  r.  3.  14, 

abforption  in  them  ;  and  then  leffened,  till  all  the  matter  is  ab- 
forbed,  which  is  brought  by  the  arteries,  inftead  of  being  depo- 
ied  in  the  ulcer. 

M.  M.  This  is  promoted  by  bandage,  by  the  forbentia  exter- 
nally, <is,  powder  of  bark,  white  lead  •,  folution  of  fugar  of  lead. 
And  by  the  forbentia  internally  after  evacuations.  See  Seel:. 
XXXIlt.  3.  2 

In  thofe  ulcers,  which  are  made  by  the  contact  of  external 
lire,  the  violent  action  of  the  tiures,  which  occafions  the  pain,  is 
liable  to  continue,  after  the  external  heat  is  withdrawn.  This 
fhould  be  relieved  by  external  cold,  as  of  mow,  fait  and  water 
recently  mixed,  ether,  or  fpiritsof  wine,  fuffered  to  evaporate  on 
the  part. 

The  cicatrix  of  aa  ulcer  generally  proceeds  from  the  edges 
of  it ;  but  in  large  ones  frequently  from  the  middle,  or  com- 
mences in  feveral  places  at  the  fame  time  j  which  probably  con- 
tributes to  the  unevennefs  of  large  fears, 

14.  Corner  obfufcatio.  Opacity  of  the  cornea.  There  are 
few  people,  who  have  pafled  the  middle  of  life,  who  have  not  at 
fome  time  fuffered  fome  flight  fcratches  or  injuries  of  the  cornea, 
which  by  not  healing  with  a  perfectly  fmooth  furface,  occafion 
fome  refractions  of  light,  which  may  be  conveniently  feen  in  the 
following  manner  :  fill  a  tea-faucer  with  cream  and  tea,  or  with 
milk,  and  holding  it  to  your  lips,  as  if  going  to  drink  it,  the  im- 
perfections of  the  cornea  will  appear  like  lines  or  blotches  on  the 
furface  of  the  fluid,  with  a  lefs  white  appearance  than  that  fur- 
face.  Thofe  blemifhes  of  the  eye  are  diftinguifhed  from  the 
mufcse  volitantes  defcribed  in  Clafsl.  2.  5.  3.  by  their  being  in- 
variably feen  at  any  time,  when  you  look  for  them. 

Ulcers  may  frequently  be  feen  on  the  cornea  after  ophthalmy, 
like  little  pits  or  indentations  beneath  the  furface  of  it  j  in  this 
cafe  no  external  application  mould  be  ufed,  left  the  fear  fhould 
be  left  uneven  ;  but  the  .cure  fhould  be  confined  to  the  internal 
ufe  of  thirty  grains  of  bark  twice  a  day,  and  from  five  to  ten 
drops  of  laudanum  at  night,  with  five  grains  of  rhubarb,  if 
neceiTary. 

After  ulcers  of  the  cornea,  which  have  been  large,  the  ine- 
qualities and  opacity  of  the  cicatrix  obfcure  the  fight :  in  this  cafe, 
could  not  a  fmall  piece  of  the  cornea  be  cut  out  by  a  kind  of 
trephine  about  the  fize  of  a  thick  briftle,  or  a  fmall  crow-quill, 
and  would  it  not  heal  with  a  tranfparent  fear  ?  This  experiment 
is  worth  trying,  and  might  be  clone  by  a  piece  of  hollow  fteel 
wire  with  a  fharp  edge,  through  which  might  be  introduced  a 
•d  fteel  fcrew  ;  the  fcrew  to  be  introduced  through  the 
;ue  cornea  to  hold  it  up,  and  prefs  itagainft  the  cutting  edge 

of 


CLASS  I.  i.  3.  14-        OF  IRRITATION.  3§> 

of  the  hollow  wire  or  cylinder  ;  if  the  fear  mould  heal  without 
lofmg  its  tranfparency,  many  blind  people  might  be  made  to  fee 
tolerably  well  by  this  flight  and  not  painful  operation.  An  ex- 
periment I  wifh  ftrongly  to  recommend  to  fome  ingenious  fur- 
geon  or  oculift. 

Or  it  may  be  attempted  by  preffing  one  end  of  a  fmall  canula 
on  the  centre  of  the  cornea,  and  paffing  down  it  a  bit  of  luna 
cornea,  fixed  in  the  end  of  a  fmaller  canula,  and  thus  introdu- 
ced :  the  eye  may  be  held  fteady  by  paffing  a  thread  by  means 
of  a  fmall  curved  needle  through  a  part  of  the  tunica  adjunfti- 
va,  which  may  be  held  by  an  affiftant,  or  by  preffing  on  it  the 
end  of  the  canula  as  above,  which  might  have  a  flat  circular  rim. 
round  its  extremity  for  that  purpofe. 


40          ,  DISEASES  CLASS  I.  i.  4.  i, 

O&DO  I. 

Increafed  Irritation. 

GENUS  IV. 

With  Increafed  Actions  of  other  Cavities  and  Membranes. 
SPECIES. 

1.  Niflitatio  irritativa.      Winking  of  the  eyes  is  performed 
every  minute  without  our  attention,  for  the  purpofe  of  cleaning 
and  moiftening  the  eye-ball  j  as  further  fpoken  of  in  Clafs  II.  i . 
I.  8.     When  the  cornea  becomes  too  dry,  it  becomes  at  the  fame 
time  lefs  tranfparent  j  which  is  owing  to  the  pores  of  it  being 
then  too  large,  fo  that  the  particles  of  light  are  refracted  by  the 
edges  of  each  pore,  inftead  of  pafling  through  it  ;  in  the  fame 
manner  as  light  is  refracted  by  pafling  near  the  edge  of  a  knife. 
When  thefe  pores  are  rilled  with  water,  the  cornea  becomes 
again  tranfparent.     This  want  of  transparency  of  the  cornea  is 
vifible  fometimes  in  dying  people,  owing  to  their  inirritability, 
and  confequent  negledft  of  nictitation. 

The  increafe  of  tranfparency  by  filling  the  pores  with  fluid  is 
feen  by  foaking  white  paper  in  oil ;  which  from  an  opaque  body 
becomes  very  tranfparent,  and  accounts  for  a  curious  atmofpher- 
ic  phenomenon  ;  when  there  exifts  a  dry  milt  in  a  morning  fo  as 
to  render  diflant  objects  lefs  diftincl:,  it  is  a  fign  of  a  dry  day  ; 
when  diftant  objecls  are  feen  very  diftin6t,,  it  is  a  fign  of  rain. 
See  Botan.  Garden,  Part  I,  add.  note  xxv.  The  particles  of  air 
are  probably  larger  than  thofe  of  water,  as  water  will  pafs 
through  leather  and  paper,  which  will  confine  air,  hence  when 
the  atmofphere  is  much  deprived  of  moifture,  the  pores  of  the 
dry  air  are  fo  large,  that  the  rays  of  light  are  refracted  by  their 
edges  inftead  of  pafling  through  them.  But  when  as  much  moif- 
ture is  added  as  can  be  perfectly  diflblved,  the  air  becomes  tranf- 
parent \  and  opaque  again,  when  a  part  of  this  moifture  collects 
into  fmall  fpherules  previous  to  its  precipitation.  This  alfo  ac- 
counts for  the  want  of  tranfparency  of  the  air,  which  is  feen  in 
tremulous  motions  over  corn-fields  on  hot  fummer-days,  or  over 
brick-kilns,  afref  the  flame  is  extinguilhed,  while  the  furnace 
itill  remains  hot. 

2.  Deglutitio  irritativa.     The  deglutition  of  our  faliva  is  per- 
formed frequently  without  our  attention,  and  is  then  an  irritative 
aclion  in  confequence  of  the  ftimulus  of  it  in  the  mouth.     Or 

perhaps 


CLASS  I.  i.  4.  3.  OF  IRRITATION.  41 

perhaps  fometimes  for  the  purpofe  of  diffufmg  a-pirt  of  it  over 
_ihe  dry   membranes    of  the  fauces  and  pharynx ;  in  the  fam-3 
manner  as  tears  are   diffufed  over  the  cornea  of  the  eye  by  the 
act  of  nictitation  to  clean  or  moiften  it. 

3.  Refpiratio  et   TuJJis  irritative.     In  the  a£ts  of  refpiration 
and  of  coughing  there  is  an  increafed  motion  of  the  air-cells  of 
the  lungs  owing  to  Come  ftimulating   caufe,  as  delcribed  above 
in  Clafs  I.  i.  2.  8.  and  I.  I.  3.  4.  and  which  are  frequently  per- 
•formed  without  our  attention  or  confcioumefs,  and  are  then  ir- 
ritative actions  j  and  thus  differ  from  thofe  defcribed  in  Clais  II. 
i.  i.  2.  and  5.     To  thefe  increafed   actions  of  the  air-cells  are 
fuperadded  thofe  of  the  intercoital  mufcies  and  diaphragm  by 
irritative  aflbciation.     When  any  unnatural  ftimulus  acts  fo  vi- 
olently on  the  organs  of  refpiration  as  to  induce  pain,  the  fenfo- 
rial  power  of  fenfation  becomes  added  to  that  of  irritation,  and 
inflammation  of  the  membranes  of  them  is  a  general  confequence. 

4.  Excltifto  bills.     The  exclusion  of  the  bile  from  the  gall-blad- 
der, and  its  derivation  into  the  duodenum,  is  an  irritative  ad  ion 
in  confequence  of  the  ftimulus  of  the  aliment  on  the  extremity 
of  the  biliary  duel,  which  terminates  in  the  inteftine.     The  in- 
creafed fecretion  of  tears  is  occafioned  in  a  limilar   manner  by 
any  ftimulating  material  in  the  eyes  ;  which  afFetts  the  excretory 
duels  of  the  lachrymal  glands.  A  pain  of  the  external  membrane 
of  the  eye  fometimes  attends  any  unufual  ftimulus  of  it,  then  the 
fenforial  power  of  fenfatioa  becomes  added  to  that  of  irritation, 
and  a  fuperficial  inflammation  is  induced. 

5.  Dentitis.     Toothing.     The  pain  of  toothing  often  begins 
much  earlier  than  is  fufpecled  ;  and  is  liable  to  produce  convul- 
fions  •,  which  are  fometimes  relieved,  when  the  gum  fwells,  and 
becomes  inflamed  ;  at  other  times  a  diarrhoea  fupervenes,  which 
is  generally  efteemed  a  favourable  circumitance,  and  feems  to 
prevent  the  convulsions  by  fupplying  another  means  of  relieving 
the  pain  of  dentition  by  irritative  exertion  ;  and  a  confequent 
temporary  exhaustion  of  fenforial  power.     See  Clafs  I.  1.2.  c. 
Sea.  XXXV.  2.  i. 

The  convulfions  from  toothing  generally  commence  long  be- 
fore the  appearance  of  the  teeth  ;  but  as  the  two  middle  incii*- 
ors  of  the  lower  jaw  generally  appear  firft,  and  then  thofe  of 
the  upper,  it  is  advifable  to  lance  the  gums  over  thefe  longitudi- 
nally in  refpecl:  to  the  jaw-bones,  and  quite  down  to  the  perios- 
teum, and  through  it. 

As  the  convulfions  attendingthe  commencement  of  toothing  are 
not  only  dangerous  to  life  in  their  greatdl  degree,  but  are  liable  to 
induce  ftupor  or  infenfibility  by  their  continuance  even  in  a  lefs 
degree,  the  moft  efficacious  means  ihould  be  ufed  to  cure  them. 

Vol.  II.  G  IVL  M.  Lance 


42  DISEASES  CLASS  I.  t.  4. 6. 

M.  M.  Lance  the  gum  of  the  expected  teeth  quite  through 
the  periofteum  longitudinally.  Venefeclion  by  the  lancet  or  by- 
two  or  three  leeches.  One  grain  of  calomel  as  a  purge.  Tinc- 
ture of  jalap,  five  or  fix  drops  in  water  every  three  hours  till  it 
purges,  to  be  repeated  daily.  After  evacuations  a  fmall  blifter 
on  the  back  or  behind  the  ears.  And  laftly,  two  or  three  drops 
of  laudanum  according  to  the  age  of  the  child.  Warm  bath. 
See  Clafs- III.  i.  i.  5.  and  & 

6.  Priapifmus  chronicus.  I  have  feen  two  cafes,  where  an 
erection  of  the  penis,  as  hard  as  horn,  continued  two  or  three 
weeks  without  any  venereal  defires,  bat  not  without  fome  pain ; 
the  eafieft  attitude  of  the  patients  was  lying  upon  their  backs 
with  their  knees  up.  At  length  the  corpus  cavernofum  urethrre 
became  fo.ft,  and  in  another  day  or  two  the  whole  fiibftded.  In 
one  of  them  a  bougie  was  introduced,  hophag  to  remove  fome 
bit  of  gravel  from  the  caput  gallinaginis,  camphor,  warm  bathing, 
opium,  lime-water,  coW  afperfion,  bleeding  in  the  veins  of  the 
penis,  were  tried  in  vain.  One  of  them  had  been  a  free  drinker, 
Lad  much  gutta  rofacea  on  his  face,  and  died  fuddenly  a  few 
months  after  his  recovery  from  this  complaint.  Was  it  a  paral- 
yfis  of  the  terminations  of  the  veins,  which  abforb  the  blood 
from  the  tumid  penis  ?  or  from  the  flimulus  of  indurated  femen 
in  the  feminal  veiTels  ?  In  the  latter  cafe  fome  venereal  defires 
fliould  have  attended.  Glafs  III.  I.  2.  16. 

The  priapifmus,  which  occurs  to  vigorous  people  in  a  morn- 
ing before  they  awake,  has  been,  called  the  fignum  falutis,  or 
banrier  of  health,  and  is  occafioned  by  the  increafe  of  our  irri- 
tability or  fenfibi! it y  during  flesp,  as  explained  in  Sect.  XVIII.  15, 

7.  Diftentio  mamrmtlarum.  The   diftention  of  the   nipples  of 
laetefcent  women  is  at  firfl  owing  to  the  flimuius  of  the  milk. 
See  Sea.  XIV.  8.  and  Sed.  XVI.  5.     See  Clafs  II.  i.   7.   10. 

8.  Dcfcenfus  uteri.     This  is  a  very  frequent  complaint  after 
bad  labours,  the  fundus  uteri  becomes  inverted  and  defcends 
like  the  prolapfus  ani. 

M.  M.  All  the  ufual  peiTaries  are  very  inconvenient  and  in- 
effectual. A  piece  of  foft  fponge  about  two  inches  diameter  in- 
troduced into  the  vagina  gives  great  eafe  to  thefe  patients,  and 
fup ports  the  uterus  ;  it  mould  have  a  firing  put  through  it  to 
retract  it  by. 

There  are  alfo  peflaries  now  made  of  elaftic  gum,  which  are 
f?jd  to  be  eafily  worn,  and  to  be  convenient,  from  their  having 
a  perforation  in  their  centre. 

9.  Prolapfus  atil.     The  lower  part  of  the  reclum  becomes  in- 
verted, and  defcends  after  every  ilool  chiefly  in  children  ;  and 
thus  flimulates  the  fphindter  ani  like  any  ether  extraneous  body. 

M.  M.  It 


CLASS  I.  i.  4.  10.     OF  IRRITATION.  43 

M.  M.  It  mould  be  d ufted  over  with  very  fine  powder  of 
gum  fandarach,  and  then  replaced.  Aftringent  fomentations  ; 
as  an  infufion  of  oakbark,  or  a  flight  iblution  of  alum.  Hori- 
zontal reft  frequently  in  the  day. 

10.  Lumbricus.  Round  worm.  The  round  worm  is  fuf- 
petled  in  children  when  the  belly  is  tumid,  and  the  countenance 
bloated  and  pale,  with  fwelling  of  the  upper  lip.  The  genera- 
tion ofthefe  worms  is  promoted  by  the  too  dilute  (late  of  the 
bile,  as  is  evident  in  the  fiukc-worm  found  in  the  biliary  duels 
^nd  fubftance  of  the  liver  in  (heep ;  and  in  water-rats,  in  the 
livers  of  which  laft  animals  they  were  lately  detected  in  large 
numbers  by  Dr.  Capelle.  Tranfactions  of  the  college  at  Phila- 
delphia, v.  i. 

Now  as  the  dilute  (late  of  the  bile  depends  on  the  deficiency 
of  the  abforption  of  its  thinner  parts,  it  appears,  that  the  tumid 
belly,  and  bloated  countenance,  and  fwelled  upper  lip,  are  con- 
comitant circumflances  attending  the  general  inactivity  of  the 
abforbent  fyftem  ;  which  is  therefore  to  be  efteemed  the  remote 
caufe  of  the  generation  of  worms. 

The  fimplicity  of  the  ftru&ure  of  worms  probably  enables 
them  to  exift  in  more  various  temperatures  of  heat ;  and  their 
being  endued  with  life  prevents  them  from  being  deftroyed  by 
digeftion  in  the  ftomach,  probably  in  the  fame  manner  as  the 
powers  of  life  prevent  the  fermentation  and  putrefaction  of  the 
ftomach  itfelf.  Hence  I  conclude,  that  worms  are  originally 
taken  into  our  alimentary  canal  from  without  •,  as  I  believe  finv 
ilar  worms  of  all  kinds  are  to  be  found  out  of  the  body. 

M.  M.  The  round  worm  is  deftroyed  by  a  cathartic  with 
four  or  fix  grains-of  calomel ;  and  afterwards  by  giving  fix  or 
eight  grains  of  filings  of  iron  twice  a  day  for  a  fortnight.  See 
Hepatis  tumor,  Clafs  I.  2.  3.  9.  As  worms  are  liable  t»  come 
away  in  fevers,  whether  of  the  hectic  or  putrid  kind,  could  they 
be  removed  by  purulent  matter,  or  rotten  egg,  or  putrid  flefh, 
fmce  in  thofe  fevers  from  the  enfeebled  action  of  the  inteftines 
the  faeces  become  highly  putrid. 

The  (harp  fpiculx  or  hairs,  which  are  found  on  the  pods  of 
cowhage,  (truolobium  filiqua  hirfuta,  have  been  recommended 
in  worm-cafes,  and  faid  to  deftroy  them  by  mechanical  puncture ; 
the  late  Mr.  Power  of  Polefworth,  aiTured  me,  he  had  had  great 
fu^cefs  with  this  medicine  and  gave  about  fix  or  eight  grains  in 
a  bolus  three  or  four  times  on  one  day,  with  a  brifk  cathartic 
on  the  next  day.  Some  have  recommended  chopped  hair  or 
bridles  for  this  purpofe.  There  are  numerous  (harp  fpiculx  in 
the  fruit  of  the  wild  rofe,  which  might  be  worth  try  ing  it  this 

difeafe,. 


44  DISEASES  CLASS!,  r.  4.  ix. 

difeafe,  and  the  hairs  en  full  grown  hairy  caterpillars,  if  the  ani- 
mal be  laid  on  the  hand,  efpecially  between  the  fingers,  are  liable 
to  flick  in  the  (kin,  and  to  produce  flight  inflammation  and  itch- 
ing, and  might  alfo  be  worth  trying  in  worm-cafes.  But  it  is 
aflerted  in  M.  Vaillant's  Travels  in  Africa,  that  when  thefe  in- 
fects feed  on  poifonous  plants,  they  become  themfelves  fo  venom- 
ous, that  the  natives  collecl:  a  juice  from  them,  with  which 

a  putrid  they  fmear  their  war  weapons  to  poifonthem. 
.   "'atria.     Tape-worm   confills  of  a  chain  of  animals    ex- 
tending from  the  ftomach  to  the  anus.     See  Seel.  XXXIX.  2.  3. 

-quently  exifis  in  cats,  rats,  and  geefe,  and  probably  in  many 

r  animals. 

The  worms  of  this  genus  poffefs  a  wonderful  power  of  re- 
taining life.  Two  of  them,  which  were  voided  by  a  pointer 
dog  in  confequence  of  violent  purgatives,  each  of  which  were 
feveral  feet  in  length,  had  boiling  water  poured  on  them  in  a 
bafin ;  which  feemed  not  much  to  inconvenience  them.  When 
the  water  was  cool,  they  were  taken  out  and  put  into  gin  or 
whi&ey  of  the  ftrongeft  kind,  in  which  their  life  and  activity 
continued  unimpaired  ;  and  they  were  at  length  killed  by  adding 
to  the  fpirit  a  quantity  of  corrofive  fublimate.  Medic.  Comment, 
for  1791,  p.  370.  ^ 

The  tape-worm  is  cured  by  an  amalgama  of  tin  and  quickfilver, 
fuch  as  is  ufed  on  the  back  of  looking-glaiTea  ;  an  ounce  fhould 
be  taken  every  two  hours,  till  a  pound  is  taken  ;  and  then  a  brilk 
cathartic  of  Glauber's  fait  two  ounces,  and  common  fait  one 
ounce,  diflblvcd  in  two  wine  pints  of  water,  half  a  pint  to  be  taken 
every  hour  till  it  purges.  The  worm  extends  from  the  ftomach 
to  the  anus,  and  the  amalgama  tears  it  from  the  inteltine  by  me- 
chanical prefiure,  a&ing  upon  it  the  whole  way.  Electric  {hocks 
through  the  duodenum  greatly  aflift  the  operation.  Large  dofes 
of  tin  in  powder.  Iron  filings  in  large  dofes.  The  powder  of 
fernroot  feems  to  be  of  no  ufe,  as  recommended  by  M.  Nouffli- 
er.  This  worm,  as  well  as  the  lumbricus  or  round-worm,  is 
fomctimes  brought  up  by  vomiting  ;  when  either  of  thefe  worms 
is  in  the  ftomach  it  gives  a  tickling  fenfation  about  the  fauces, 
which  parts  fympathize  with  the  cardia  ventriculi.  See  Annals 
cf  Medicine,  1 797.  "Give  an  emetic  oftartarized  antimony,  or 
of  vitriol  of  zinc. 

12. Afcarides.  Threadworms.  Thefe  worms  are  faid  to  be  more 
frequent  in  fome  parts  of  this  kingdom  than  in  others,  as  near 
the  fens  of  Lincolnfhire.  Do  they  efcape  from  the  body  and  be- 
come flies,  like  the  bott-worm  in  horfes  ?  Do  they  crawl  from 
one  child  to  another  in  the  fame  bed  ?  Are  they  acquired  from 
flies  or  worms,  which  are  feen  in  putrid  neceflary  houfes,  us 


CLASS  Li.*  12.  OF  IRRITATION.  45 

-ms  as  wallas  the  tap?,  -verms,  are  "probably  acquired 
from  without  ?  this  may  account  for  their  re-appearance  a  few- 
weeks  cr  months  after  they  have  been  destroyed  ;  or  can  this 
happen  from  the  eggs  or -parts  of  them  remaining  ? 

Afcaiides  appearto  be  of  two  kinds,  the  common  fmall  one 
like  a  thread  ;  which  has  a  very  {harp  head,  as  appears  in  the  mi- 
crofcope  ;  and  which  is  fo  tender,  that  the  cold  air  foon  renders 
it  mqrionlefo  ;  and  a  larger  kind  above  an  inch  long,  and. nearly 
as  thick  as  a  very  fmall  crow-quill,  and  which  is  very  hard  in  re- 
fpect  to  its  texture,  and  very  tenacious  of  life.  One  of  thefe  laft 
was  brought  to  me,  and  was  immediately  immerfed  in  a  ftrong 
foiution  of  fugar  of  lead,  and  lived  in  it  a  very  long  time  without 
apparent  inconvenience. 

1VI.  M.  Afcarides  are  faid  to  be  weakened  by  twenty  grains 
of  cinnabar  and  live  of  rhubarb  taken  every  night,  but  not  to  be 
cured  by  this  procefs.  As  thefe  worms  are  found  only  in  the 
rectum,'  variety  of  clyfters  have  been  recommended.  A  clyfter 
confiding  of  one  eighth  or  one  fourth  of  an  ounce  of  fuccotrine 
aloes  in  powder  boiled  in  3  pint  of  milk  cr  of  gruel,  till  it  is  dif- 
folved,  and  injected  once  a  week  for  many  weeks,  I  believe  has 
fometimes  effected  a  cure.  I  was  informed  of  3  cafe,  where  fo- 
Jutions  of  mercurial  ointment  were  ufed  as  a  clyfter  every  night 
for  a  month  without  fuccefs.  Clyfters  of  Harrowgate  water  arc 
recommended,  either  of  the  natural,  or  of  the  factitious,  as  de- 
fcribed  below,  which  might  have  a  greater  proportion  of  liver 
of  fulphur  in  it.  As  the  cold  air  foon  deftroys  them,  after  they 
are  voided,  could  clyfters  of  iced  water  be  ufed  with  advantage  ? 
or  of  fpirit  of  wine  and  water  ?  or  of  ether  and  water  ?  Might 
not  a  piece  of  candle,  about  an  inch  long,  or  two  fuch  pieces, 
fmeared  with  mercurial  ointment,  and  introduced  into  the  anus 
at  night,  or  twice  a  day,  be  effectual  by  compreiling  their  nidus, 
as  well  as  by  the  poifon  of  the  mercury  ? 

The  clyfters  (hould  be  large  in  quantity,  that  they  may  pafs 
high  in  the  rectum,  as  two  drams  of  tobacco  boiled  a  minute  in 
a  pint  of  water.  Or  perhaps  what  might  be  (till  more  effica- 
cious and  lefs  inconvenient,  the  fmoke  of  tobacco  injected  by 
a  proper  apparatus  every  night,  or  alternate  nights,  for  fix  or 
eight  weeks.  This  was  long  fince  recommended,  I  think,  by 
Mr.  Turner  of  Liverpool  ;  and  the  reafon  it  has  not  fucceeded, 
I  believe  to  have  been  owing  to  the  imperfections  of  the  joints 
of  the  common  apparatus  for  injecting  the  fmoke  of  tobacco,  fo 
that  it  did  not  pals  into  the  inreftine,  though  it  was  fuppofed  to 
do  fo,  as  I  once  obferved.  The  fmoke  fhould  be  received  from 
the  apparatus  into  a  large  bladder  ;  and  it  may  then  be  certainly  in- 
jected like  the  common  clyfter  with  fufficient  force  ;  otherwife 

oiled 


4-6  DISEASES  CLASS  I.  1.4.  13. 

piled  leathers  fhould  be  nicely  put  round  the  joints  of  the  ma- 
chine 5  and  a  wet  cloth  round  the  injecting  pipe  to  prevent  the 
return  of  the  fmoke  by  the  fides  of  it.       Clyfters  of   carbonated  v 
hydrogen  gas,  or  of  other  factitious  airs,  might  be  tried  ;  or  of 
the  hairs  of  filiqua  hirfuta. 

Harrowgatc  water  taken  into  the  ftomach,  fo  as  to  induce  fix 
or  feven  llools  every  morning,  for  four  or  fix  weeks,  is  perhaps 
the  moli  efficacious  method  in  common  ufe.  A  factitious  Har- 
rowgate  water  may  be  made  probably  of  greater  efficacy  than 
the  natural,  by  difiblving  one  ounce  of  marine  fait,  (called  bay 
fait)  and  half  an  ounce  of  magnefia  Glauber's  fait,  (called  Epfom 
fait,  or  bitter  purging  fait)  in  twenty-eight  ounces  of  water.  A 
quarter  or  half  a  pint  of  this  is  to  be  taken  every  hour,  or  two 
hours  in  the  morning,  till  it  operates,  with  a  tea-fpoonful  of  a 
folntion  of  liver  of  fulphur,  which  is  to  be  made  by  putting  an 
ounce  of  hepar  fulphuris  into  half  a  pint  of  water.  See  Clafs 

IV.    I.   2.  9. 

13.  Qracunculus.      A  thin  worm  brought  from  the  coaft   of 
Guinea.     It  is  found  in  the  interftices  of  the  mufcles,  and  is 
many  yards    long  j  it  makes  a  fmall  ulcer-,  which  is  cured  by 
extracting  an  inch  of  the  worm  a  day,  and  wrapping  the  extract- 
ed part  ilowly  round  a  bit  of  tobacco-pipe  till  next  day,  fo  as  not 
to  break  it.     I  have  twice  feen  long  worms,  like  a  thick  horfe 
hair,  in  water  in  July  in  this  country,  which  appeared  hard  and 
jointed. 

14.  Morpiones.     Crab-lief.     The  excrement   of  this    animal 
Plains  the  linen,  and  appears  like  diluted  blood. 

M.  M.  Spirit  of  wine.  Mercurial  ointment,  (having  the  part. 
Oil  deflroys  other  infects,  if  they  be  quite  covered  with  it,  as  the 
ticks  on  dogs,  and  would  probably  therefore  deflroy  thefe.  Its 
manner  of  operation  is  by  (lopping  up  or  filling  their  fpiracula, 
pr  breathing  pores  ;  a  few  drops  of  oil  poured  on  a  wafp,  fo  as 
to  cover  it,  deflroy  it  in  a  few  feconds. 

15.  Pedkidl.     Lice.     There  is  faid  to  be  a  difeafe,  in  which 
thefe  animals  are  propagated  in  indeftructible  numbers,  fo  as  to 
deflroy  the  patient. 

M.  M.  Cleanlinefs,  mercurial  ointment,  ftavisacria in  powder, 
pr  the  tincture  of  it  in  fpirit  of  wine.  Spirit  of  wine  alone.  ? 
Uath  of  oil  ? 


ORDO 


CLASS  I.  i.  5.  i.          OF  IRRITATION.  47 

ORDO  I. 

Increnfid  Irritation. 

GENUS  V. 

With  incrcafid  Afiions  of  the  Organs  afSenfe. 
SPECIES. 

1.  Vifus  acrior.     Acutcr  fight.     There  have  been  inltanccs  of 
people,  who  could  ice  better  hi  the  gloom  of  the  evening,  than' 
in  the  (Ironger  light  of  the  day  ;  like  owls,  and  bats,  and  man? 
quadrupeds,  and  flying  inlets.     When  the  eye  is  inflamed,  great 
light  becomes  eminently  painful,  owing  to  the  incrcafcd  i; 
tive  motions  of  the  retina,  and  the  coniequent  incrcafed  fcnia- 
tion.     Thus  when  the  eye  is  dazzled  with  fuddcn  light,  the  pain 
is  not  owing  to  the  motion  of  the  iris  ;  for  it  is  the  Contraction 
of  the  iris,  which  relieves  the  pain  from  fudden  light  \  but  to  the 
too  violent  contractions  of  the  moving  fibres,  which  cunflitute 
the  extremities  of  the  optic  nerve. 

2.  Audit  us  acrior.     The  irritative  ideas  of  hearing  are  fo  in- 
creafed  in  energy  as  to  excite  our  attention.     This  happens  in 
fome  difeafes  of  the  epileptic  kind,  and  in  fome  fevers.     Hence 
the  whifpering  of  the  currents  of  air  in  a  room,  the  refpiration 
of  the  company,  and  noiies  before  unperceived,  become  trouble- 
fome  ;  and   founds  louder  than  ufual,  or  uaexpeded,  produce 
ftarting,  and  convulfions. 

M.  M.  Put  oil  of  almonds  into  the  ears.  Stop  the  meatus 
auditorius  with  cotton  wool.  Set  the  feet  of  the  patient's  bed 
on  cufhions,  or  fufpcnd  it  by  cords  from  the  ceiling. 

3.  Olfaclus  acrior.     The  irritative  ideas  of  fmeli  from  the  in- 
creafed  action  of  the  olfaclive  nerve  excite  our  attention.  Hence 
common  odours  are  difagreeable  ;  and  are  perceived  from  vari- 
ety of  objects,   which  were  before  thought  inodorous.     Theie 
are  commonly  believed  to  be  hallucinations  of  the  fenfe. 

M.  M.  SnufFftarch  up  the  noftrils. 

4.  Gujlus  acrior.     The  irritative  ideas  of  tafte,  as  of  our  own 
faliva,  and  even  of  the  atmofpheric  air,  excite  our  attention  5  and 
common  taites  are  difagreeably  ilrong. 

M.  M.  Water.  Mucilage.  Vegetable  acids.  Scrape  the 
tongue  clean.  Rub  it  with  a  fage-leaf  and  vinegar. 

5.  Tnclus  acrior.     The  irritative  ideas  cf  the  nerves  of  touch 

excite 


48  DISEASES  CLASS  I.  i.  5.  6. 

excite  our  attention  :  hence  our  own  pveflure  en  the  parts,  we 
reft  upon,  becomes  uneafy  with  univerfal  forenefs. 

M.  M.  Soft  feather-bed.  Combed  wool  put  under  the  pa- 
tients, which  rolls  under  them,  as  they  turn,  and  thus  prevents 
their  friction  againft  the  meets.  Drawers  of  foft  leather.  Plat- 
ters of  cerate  with  caiamy. 

6-  Senfus  caloris  acrior.  Acuter  fenfe  of  heat  occurs  in  fome 
difeafes,  and  that  even  when  the  perceptible  heat  does  not  appear 
greater  than  natural  to  the  hand  of  another  perfon.  See  Ciafs 
I.  i.  2.  See  Seel:.  XIV.  8.  -All  the  above  increafed  actions  of 
cur  organs  of  fenfe  feparately  or  jointly  accompany  fome  fevers, 
and  fome  epileptic  difeafes  ;  the  patients  complaining  of  the  per- 
ception of  the  leaft  light,  noifes  in  their  ears,  bad  fmells  in  the 
room,  and  bad  taftes  in  their  mouths,  with  forenefs,  numbriefs, 
2nd  other  uneafy  feels,  and  with  difagreeable  fenfations  of  gen- 
eral or  partial  heat. 

7.  Senfus  extenftonis  acrior.     Acuter  fenfe  of  extenfion.     The 
fenfe  of  extenfion  was  fpoken  of  in  Se£l.  XIV.  7.  and  XXXII. 
4.     The  defecl:  of  diftention  in  the  arterial  fyftem  is  accompani- 
ed with  faintne£s  5.  and  its  excefs  with  fenfations  of  fulnefs,  or 
weight,  or  preffure.     This  however  refers  only  to   the  vafcular 
mufcles,  which  are  di (tended  by  their  appropriated  fluids ;  but 
the  longitudinal  mufcles  are  alfo  affecled  by  different  quantities 
of  extenfion,  and  become  violently  painful  by  the  excefs  of  it. 

Thefe  pains  of  mufcles  and  of  membranes  are  generally 
divided  into  acute  and  dull  pains,  The  former  are  generally 
owing  to  increafe  of  extenfion,  as  in  pricking  the  Ikin  with  a 
needle  ;  and  the  latter  generally  to  defect  of  extenfion,  as  in 
cold  head-aches  ;  but  if  the  edge  of  a  knife,  or  point  of  a  pin, 
be  gradually  preiTed  againft  the  fibres  of  mufcles  or  membranes, 
there  would  feem  to  be  three  Mates  or  flages  of  this  extenfion  of 
the  fibres  ;  which  have  acquired  names  according  to  the  degree 
or  kind  of  fenfation  produced  by  the  extenfion  of  them  ;  thefc 
are  i.  titillation  or  tickling  ;  2-  itching  ;  and  the  3.  fmarting, 
as  defcribed  below.  See  Sea.  XIV.  9, 

8.  Titillatio,     Tickling  is  a  pleafurable  pain  of  the    fenfe  of 
extenfion  above  mentioned,  and  therefore  excites  laughter  ;  as 
defcribed  in  Sea.  XXXIV.    r.  4.     The  tickling  of  the  nortrils, 
which  precedes  the  efforts  of  fneezing,  is  owing  to  the  increafed 
irritation  occafioned  by  external  ftimulus  ;  and  is  attended  with 
a  pleafurable  fenfation  in  confequence  of  the  increafed  aaion  of 
the  part.     When  this  aaion  is  exerted  in  a  greater  degree,  the 
fenfation  becomes  painful,  and  the  convulfion  of  fneezing  en- 
fues ;  as  the  pain  in  tickling  the  foles  of  the  feet  of  children  is 
relieved  by  laughter. 

A 


CLASS  I.  i.  5.  9-      °F  IRRITATION.  4y 

A  lady  after  a  bruife  on  her  nofe  by  a  fall  was  affected  with 
incefiant  fneezing,  and  relieved  by  fnufling  ftarch  up  her  noftrils. 
Perpetual  freezings  in  the  mealies,  and  in  catarrhs  from  cold, 
are  owing  to  the  ftimulus  of  the  faline  part  of  the  mucous  effu- 
(inn  on  the  membrane  of  the  noftrils.  See  Clafs  II.  i.  1.2. 

9.  Pruritus.     Itching  feems  to  be  a  greater  degree  of  titilla- 
tion,  and  to  be  owing  to  the  ftimulus  of  fome  acrid  material,  as 
the  matter  of  the   itch  ;  or  of  the  herpes   on  the  fcrotum,  and 
about  the  anus  ;  or  from  thofe  univerfal  eruptions,  which  attend 
fome  elderly   people,  who  have  drunk  much   vinous  fpirit.     It 
occurs  alfo,  when  inflammations  are  declining,  as  in  the  healing 
of  blifters,  or  in  the  cure  of  ophthalmia,  as  the  action  of  the  vef- 
fels  is  yet  fo  great  as  to  produce  fenfation  ;  which,  like  the  titil- 
lations  that  occafion  laughter  j  is  perpetually  changing  from  plcaf- 
ure  to  pain. 

When  the  natural  efforts  of  fcratching  do  not  relieve  the  pain 
of  itching,  it  fometimes  increafes  fo  as  to  induce  convulfions  and 
madnefs.  As  in  the  furor  uterinus,  and  fatyriafis,  and  in  the 
fphinfter  ani  and  fcrotum.  See  Clafs  II.  1.4.  14.  IV.  2.  2.  6. 

M.  M.  Warm  bath.  Fomentation.  Alcohol  externally. 
Poultice.  Oiled  filk.  Mercurial  ointments  on  fmall  furfaces  at 
once.  See  Clafs  II.  1.4.  12.  Solutions  of  lead  on  fmall  fur- 
faces  at  once. 

10.  Dolor  urens.     Smarting  follows  the  edge  of  a  knife  in  ma- 
king a  wound,  and  feems  to  be  owing  to  the  diitention  of  apart 
of  a  fibre,  till  it  breaks.     A  fmarting  of  the  fkin  is  liable  to  af- 
fcLt  the  fears  left  by  herpes  or  fhingles  ;  and  the  callous  parts  of 
the  bottoms  of  the   feet  \  and  around  the  bafes  of  corns  on  the 
toes  •,   and  frequently  extends  after  fciatica  along   the  outhde  of 
the  thigh,  and  of  the  leg,  and  part  of  the  foot.     Ail  thefe  may 
be  owing  to  the  ftimulus  of  extenfion,  by  blood  or   ferum  being 
forced  into  vefleis  nearly  coalefced. 

M.  M.  Emplaftrum  de  minio  put  like  a  bandage  on  the  part. 
Warm  fomentation.  Oil  and  camphor  rubbed  on  the  part.  Oil- 
filk  covering.  A  blifter  on  the  part.  Ether,  or  alcohol,  fuffer- 
ed  to  evaporate  on  the  part. 

n.  Confternatio.     Surprife.     As  our  eyes  acquaint  us  at  the 
fame  time  with  lefs  than  half  of  the  objects,  which  furround  us, 
we  have  learned  to  confide  much  in  the  organ  of  hearing  to  warn 
us  of  approaching  dangers.     Hence  it  happens,  that  it  any  found 
itrikes  us,  which  we  cannot  immediately  account  for,  our  fears 
are  inftantly  alarmed.     Thus  in  great  debility  of  body,  the  loud 
clapping  of  a  door,  or  the  fall  of  a  fire-movel,  produces  a!. 
and  fometimes  even  convulfions  ;  the  fame  occurs  frr 
peeled  fights,  and  in  the  dark  from  unexpected  ob' .  .. 

VOL,  II.  H  la 


co  DISEASES  CLASS  I.  i.  5.  i  r. 

In  thefe  cafes  the  irritability  is  lefs  than  natural,  though  it  is 
erroneoufly  fuppofed  to  be  greater  j  and  the  mind  is  bufied  in 
exciting  a  train  of  ideas  inattentive  to  external  objefts  ;  when 
this  train  of  ideas  is  difievered  by  any  unexpected  ftimulus,  fur- 
prifeis  excited  ;  as  explained  in  Sect.  XVII.  3.  7.  and  XVIII. 
17.  then  as  the  fenfibility  in  thefe  cafes  is  greater,  fear  becomes 
fuperadded  to  the  furprife  ;  and  convuliions  in  confequence  of 
the  pain  of  fear.  See  Sect.  XIX.  2. 

The  proximate  caufe  of  furprife  is  the  increafed  irritation  in- 
duced by  fome  violent  ftimulus,  which  dilTevers  our  ufual  trains 
of  ideas  ;  but  in  difeafes  of  inirritability  the  frequent  ftarting  or 
furprife  from  founds  not  uncommon,  but  rather  louder  than  ufu- 
al, as  the  clapping  of  a  door,  mews,  that  the  attention  of  the  pa- 
tient to  a  train  of  fenfitive  ideas  was  previoufly  ftronger  than 
natural,  and  indicates  an  incipient  delirium  j  which  is  therefore 
worth  attending  to  in  febrile  difeafes* 


ORDO 


CLASS  I.  2.  i.  OF  IRRITATION.  5 1 

ORDO  II. 
Decreafed  Irritation* 

GENUS  I. 

With  decreafed  AB'wn -of  the  Sangitiferous  SyJIem. 

THE  reader  mould  be  here  apprized,  that  the  words  flrength 
and  debility,  when  applied  to  animal  motions,  may  properly  cx- 
prefs  the  quantity  of  refiftance  fuch  motions  may  overcome  ;  but 
that,  when  they  are  applied  to  mean  the  fiifecptibility  or  i: 
reptibility  of  animal  fibres  to  motion,  they  become  metaphorical 
terms  ;  as  in  Sect.  XII.  2-  i.  and  would  be  better  expreiled  by 
the  words  activity  and  inactivity. 

There  are  three  fources  of  animal  inactivity  ;  firft,  the  d 
of  the  natural  quantity  of  ftimulus  on  thofc  fibres,  which  . 
been  accuftomed  to  perpetual  ftimulus  ;    as  the  arterial  and  fe- 
cerning  fyftems.     When    their   accuftomed   ftimulus    is   for  a 
while   intermitted,  as  when   fnow  is  applied  to  the  ikin  of  the 
hands,  an  accumulation  :of  fenforial  power  is  produced  \  and then 
a  degree  of  ftimulus,  as  of  heat,  fomewhat  greater  than   th 
prefent  applied,  though  much  lefs  than  the  natural  quantity,  ex- 
cites the  vefTels  of  the  fkin  into  violent  action.     We  muft  ob- 
ferve,  that  a  deficiency  of  ftimulus  in   thofe  fibres,   which  arc 
not  fubject  to  perpetual  ftimulus,   as  the  locomotive  mufcllk 
is   not  fucceeded  by  accumulation  of  fenforial  power  -,    thefe 
therefore  are  more  liable  to  become  permanently  inactive  after 
a  diminution  of  ftimulus ;  as   in  ftrokes  of  the  palfy,  this  may 
be  called  inactivity  from  defect:  of  ftimulus. 

2.  A  fecond  fource  of  animal  inactivity  exifts,  when  the  fen- 
forial power  in  any  part  of  the  fyftem  has  been  previouily  ex- 
haufted  by  violent  ftimuli  ;  as  the  eyes   after  long  expofure  to 
great  light  ;  or  the   ftomach,  to   repeated  fpirituous   potation  ; 
this  may  be  termed  inactivity  from  exhauftion  of  fenforial  pow- 
er.    See  Sed.  XII.  2.  i. 

3.  But  there  is  a  third  fource  of  inactivity  owing  to  the  defi- 
cient production  of  fenforial  power  in  the  brain  ;  and  hence 
ftimuli  ftronger  than  natural  are  required  to  produce  the  accuf- 
tomed motions  of  the  arterial  fyftem  ;  in  this  cafe  there  is  1,10 
accumulation  of  fenforial  power  produced  ;  as  in  the  inactivity 
owing  to  defect  of  ftimulus  ;  nor  any  previous  exhauftion  of  it, 
as  in  the  inactivity  owing  to  excefs  of  ftimulus. 

This  third  kind  of  inactivity  caufes  many  of  the  difeafes  of 
this  genus  j  which  are  therefore   in  general  to  be  remedied  by 

fucl> 


S2  DISEASES  CLASS  I.  2.  r.  ri 

fuch  medicines  as  promote  a  greater  production  of  fenforial  i 
er  in  the  brain  ;  as  the  incitantia,  confuting  of  wine,  beer  and 
opium,  in  finall  repeated  quantities  ;  and  Secondly  of  fuch  as 
fimply  ftimulate  the  arterial  and  gbnduhr  fyftem  into  their  nat- 
ural actions  ;  as  fmall  repeated  blifters,  fpices  and  eiTential  oil:;. 
And  laftly  the  forbentia,  which  contribute  to  fupply  the  more 
permanent  ftrength  of  the  fyftem,  by  promoting  the  abforption 
of  nouriihment  from  the  flomach  and  inteftinesj  and  of  the  fu~ 
perfluous  fluid,  which  attends  the  fecretions. 

SPECIES. 

I.  Febris  mirritativa.  Inirritative  fever.  This  is  the  typhus 
mitior,  or  nervous  fever  of  fome  writers  j  it  is  attended  with 
weak  pulfe  without  inflammation,  or  fymptoms  of  putridity,  as 
they  have  been  called.  When  the  production  of  fenforial  pow- 
er in  the  brain  is  lefs  than  ufual,  the  pulfe  becomes  quick  as  well 
as  weak  ;  and  the  heart  fometimes  trembles  like  the  limbs  of 
old  age,  or  of  enfeebled  drunkards  ;  and  when  this  force  of  the 
contractions  of  the  heart  and  arteries  is  diminimed,  the  blood  is 
puihed  on  with  lefs  energy,  as  well  as  in  lefs  quantity,  and  thence 
its  ftimulus  on  their  (ides  is  diminifhed  in  a  duplicate  ratio.  In 
compreflions  of  the  brain,  as  in  apoplexy,  the  pulfe  becomes 
flower  and  fuller  ;  for  in  that  difeafc,  as  in  natural  ileep,  the  irri- 
tative motions  of  the  heart  and  arteries  are  not  diminiihed,  voli- 
tion alone  is  fufpended  or  deftroyed. 

If  the  abforption  of  the  terminations  of  the  veins  is  not  equal- 
ly impaired  with  the  force  of  the  heart  and  arteries,  the  blood  is 
taken  up  by  the  veins  the  inftant  it  arrives  at  their  extremities  ; 
the  capillary  veflels  are  left  empty,  and  there  is  lefs  reliftance  to 
the  current  of  the  blood  from  the  arteries  ;  hence  the  pulfe  be^ 
comes  empty,  as  well  as  weak  and  quick  \  the  veins  of  the  fkin 
are  fuller  than  the  arteries  of  it  ;  and  its  appearance  becomes 
pale,  bluifti,  and  {hrunk.  See  Clafs  II.  1.3.  I. 

When  this  pulfe  perfifts  many  hours,  it  conftitutes  the  febris 
inirritativa,  or  typhus,  or  nervous  fever,  of  fome  writers  ;  it  is 
attended  with  little  heat,  the  urine  is  generally  of  a  natural  col- 
cur,  though  in  lefs  quantity  ;  with  great  proftration  of  ftrength, 
and  much  difturbance  of  the  faculties  of  the  mind.  Its  imme- 
diate caufe  feerns  to  be  a  deficient  fecretion  of  the  fenfcrial  pow- 
er from  the  inaction  of  the  brain  \  hence  almoft  the  whole  of 
the  fenforial  power  is  expended  in  the  performance  of  the  mo- 
tions neceflary  to  life,  and  little  of  it  can  be  fpared  for  the  volun- 
tary actions  cf  the  locomotive  mufcles,  or  organs  of  fenfe,  fee 
'Clafs  I.  2.  5.  3.  Its  more  remote  caufe  may  be  from  a  paraly- 


CLASS  I.  2.  K  2.          OF  IRRITATION.  53 

fis.  or  death  of  iome  other  part  of  the  body  ;  as  of  the  fpleen, 
when  a  tumour  i;,  felt  on  the  left  fide,  as  in  fome  intennittents ; 
or  of  th>;  -  when  the  urine  continues  pale  and  in  imall 

•tity.  Docs  the  revivefcence  of  theie  affected  parts,  or  their 
torpor,  recurring  at  intervals,  form  the  paroxyfms  of  theft  fevers  ? 
and  their  permanent  revivefcence  eftabliih  the  cure  ?  See  Clais 
IV.  2.  I.  19. 

The  inirritative  fever  differs  from  the  puerperal  and  from  the 
hectic  fever,  by  the  permanent  inactivity  of  the  ftomach,  which 
in  this  difeafe  admits  of  no  folid  nutriment.  See  Clafs  II.  i.  6. 
1 6.  and  Suppl.  I.  12. 

M.  M.  Wine  and  opium  in  fmall  quantities  repeated  every 

'  three  hours  alternately  j  fmall  repeated  blifters  ;  warm  but  f  re  ill 

air;  forbentia  ;  nutrientia  ;  transfufion  of  blood.     Small  electric 

ilioc".  ihvough  the  brain  in  all  directions.     Oxygene  air  ? 

2.  Purefts  imrritaii'va.     Inirritative  debility.     A  defective  ac- 
tion of  the  irritative  motions  without  increafe  of  the  frequency 
of  the  pulfe.     It  continued  three  or  four  weeks  like  a  fever,  and 
then  either  terminates  in  health,  or  the  patient  finks  into  one  kind 
of  apoplexy,  and  perifhes.  Many  fymptoms,  which  attend  ini; 
tive  fevers,  accompany  this  difeafe,  as  cold  hands  and  feet  ai 
riodic  times,    fcurf  on   the  tongue,  want  of   appetite,    muddy 
urine,  with  pains  of  the  head,  and  fometimes  vertigo,  and  vom- 
iting. 

This  difeafe  differs  from  the  inirritative  fever  by  the  pulfe 
not  being  more  frequent  than  in  health.  The  want  of  appetite 
and  of  digeftion  is  a  principal  fymptorn,  and  probably  is 
cr.ufe  of  the  umverfal  debility,  which  may  be  occafioned  by  the 
want  of  nouriihrnent.  The  vertigo  is  a  fymptom  of  inirritabil- 
ity,  as  fhcwn  in  Clafs  IV.  i.  2.  6.  the  muddy  urine  is  owing  to 
increafcd  abforption  from  the  bladder  in  ccnfequence  of  the  di- 
minifhed  cutaneous  and  cellular  abforption,  as  in  anafarca,  ex- 
plained in  Sect.  XXIX.  5.  i.  and  is  therefore  a  confequence  of 
the  inirritability  of  that  part  of  the  fyftem  ;  the  foul  tongue  is 
owing  to  an  increafed  abforption  of  the  thinner  part  of  the  mu- 
cus in  confequence  of  the  general  deficiency  of  fluid,  which 
fhould  be  abforbed  by  the  (kin  and  ftomach.  The  ficknefs  is  ow- 
ing to  decreafed  action  of  the  ftomach,  which  is  probably  the 
primary  difeafe,  and  is  connected  with  the  vertigo. 

M.  M.  An  emetic.  Calomel,  grains  iv.  once  or  twice.  Then 
a  bliiter.  Peruvian  bark.  Valerian.  Columbo.  Steel.  Opi- 
um and  wine  in  fmall  quantities,  repeated  alternately  every  three 
hours.  Small  electric  percuffions  through  the  ftomach. 

3.  Somnus  interritptiis.      Interrupted  ileep.     In   fome   fevers, 
where  the  inirritability  is  very  greai>  when  the  patient  falls  afleep, 

the 


54  DISEASES  CLASS!.  2.  i.  4." 

the  pulfe  In  n  few  minutes  becomes  irregular,  and  the  patient 
awakes  in  great  diforder,  and  fear  of*  dying,  refufing  to  ileep  again 
from  the  terror  of  this  uneafy  fenfation.  In  this  extreme  debil- 
ity there  is  reafon  to  believe,  that  fome  voluntary  power  during 
our  waking  hours  is  employed  to  aid  the  irritative  ftimuli  in 
carrying  on  the  circulation  of  the  blood  through  the  lungs  ;  in 
the  lame  manner  as  we  ufe  voluntary  exertions,  when  we  liften 
to  weak  foimds,  or  wifh  to  view  an  object  by  a  fmall  light ;  in 
ileep  volition  is  fufpended,  and  the  deficient  irritation  alone  is 
not  fufficient  to  carry  on  the  pulmonary  circulation.  This  ex- 
planation feems  the  moft  probable  one,  becaufe  in  cafes  of  apo- 
plexy the  irritative  motions  of  the  arterial  fyflem  do  not  feem  to 
be  impaired,  nor  in  common  fleep.  See  Incubus  III.  2.  i.  13. 
M.  M.  Opium  in  very  fmall  dofes,  as  three  drops  of  lauda- 
num, A  perfon  (hould  watch  the  patient,  and  awaken  him  fre- 
quently j  or  he  mould  meafure  the  time  between  11  umber  and 
fiumber  by  a  ftop- watch,  and  awaken  the  patient  a  little  before  he 
would  otherwife  awake  ;  or  he  mould  keep  his  finger  on  the 
pulfe,  and  fhould  forcibly  awaken  him,  as  foon  as  it  becomes  ir- 
regular, before  the  diforder  of  the  circulation  becomes  fo  great 
as  to  diflurb  him.  See  Clafs  I.  2.  i.  9.  and  Sect.  XXVII.  2. 

4.  Syncope.     Fainting  confifts  in  the  decreafed  action  of  the 
arterial  fyitem  \  which  is  fometimes  occafioned  by  defecl:  of  the 
ftimulus  of  detention,  as  after  venefeclion,  or  tapping  for  the 
clropfy.     At  other  times  it  arifes  from  great  emotions  of  the 
mind,  as  in  fudden  joy  or  grief.     In  thefe  cafes  the  whole  fenfo-' 
rial  power  is  exerted  on  thefe  interefting  ideas,  and  becomes  ex- 
haufted.     Thus  during  great  furprife  or  fear  the  heart  flops  for 
a  time,   and  then  proceeds  with   throbbing  and  agitation ;  and 
fometimes  the  vital  motions  become  fo  deranged,  as  never  to  re- 
cover their  natural  fucceffive  action  ;  as  when  children  have  been 
frightened  into  convulfions.     See  Seel:.  XII.  7.  i. 

Mifs ,  a  young  lady  of  Stafford,  in  travelling  in  a  chaife 

was  fo  affe6ted  by  feeing  the  fall  of  a  horfe  and  poftillion,  in  go- 
ing down  a  hill,  though  the  carriage  was  not  overturned,  that 
{he  fainted  away,  and  then  became  convulfed,  and  never  fpoke 
afterwards  ;  though  me  lived  about  three  days  in  fucceffive  con- 
vulfions and  ftupor. 

5.  Hamorrhagia  vcncfa.     A  bleeding  from  the  capillaries  ari- 
£ng  from  defect  of  venous  abforption,  as  in  fome  of  thofe  fevers 
commonly  termed  putrid.    When  the  blood  ftagnates  in  the  cel- 
3-jlnr  membrane,  it  produces  petechice  from  this  torpor  or  paraly- 

•i:rhe  abforbent  mouths  of  the  veins.  It  muft  be  obferved, 
that  thofe  people  who  have  difeafed  livers,  are  more  liable  to  this 
kind  of  hsemorrhagesj  as  well  as  to  the  hiemorrhagia  arteriofa  ; 

the 


CLASS  I.  2.  i.  6.        OF  IRRITATION.  5$ 

the  former,  becaufe  patients  with  difeafed  livers  are  more  fubjeft 
to  paralytic  complaints  in  general,  as  to  hemiplegia,  and  to  drop- 
fy,  \vhich  is  a  paralyfis  of  the  lymphatics  ;  and  the  latter  is 
probably  owing  to  the  delay  of  the  circulation  in  the  vena  por- 
ta  by  the  torpor  of  this  hepatic  vefTel,  when  the  liver  is  not 
much  enlarged  j  and  to  its  preffure  on  the  vena  cava,  when  it  is 
much  enlarged. 

I  have  feen  two  elderly  men,  and  one  middle  aged  woman,  all 
of  whom  had  drunk  too  much  fermented  or  fpirituous  liquors, 
and  had  been  for   fome  months  gradually  finking,  were   feized 
with  a  ceafclefs  haemorrhage  from  their  mouths,  and  from  every 
part  of  the  Ikin,  where  they  happened  to   fcratch  themfelves, 
which  continued  fome  days  till  they  died.     See  Sect.  XXVII.  2. 
M.  M.     Vitriolic  acid,  opium,  fteel,  bark.     Sponge  bound 
on  the  part.     Steel  diflblved  in  fpirit  of  wine  externally.  Flour. 
6.  Hamorrhois  cruenta.     In  the  bleeding   piles  the  capillary 
veffels  of  the  rectum  become  diftended  and  painful  from  the  de- 
fect of  the  venous  abforption  of  the  part,  and  at  length  burft  ; 
or  the  mucous  glands  are  fo  dilated  as  to  give  a  pafTage  to  the 
blood  ;  it  is  faid  to  obferve  lunar  periods. 

M.  M.  Venefection,  poultices,  cathartics,  fpice,  cold  bath, 
and  forbentia.  External  comprefllon  by  applying  lint,  fponge, 
or  cotton.  Internal  compreffion  by  applying  a  bit  of  candle 
fmeared  with  mercurial  ointment.  Strangulate  the  tumid  piles 
with  a  filk  firing.  Cut  them  off.  See  Sed.  XXVII.  2. 

Mrs. had  for  twelve   or   fifteen  years,  at  intervals  of  a 

year  or  lefs,  a  bleeding  from  the  rectum  without  pain  ;  which 
however  flopped  fpontaneoufly  after  fhe  became  weakened,  or 
by  the  ufe  of  injections  of  brandy  and  water.  Lately  the  bleed- 
ing continued  above  two  months,  in  the  quantity  of  many  ounces 
a  day,  till  fhe  became  pale  and  feeble  to  an  alarming  degree. 
Injections  of  folutions  of  lead,  of  bark  and  fait  of  fteel,  arid  of 
turpentine,  with  fome  internal  aftringents,  and  opiates,  were  ufed 
in  vain.  An  injection  of  the  fmoke  of  tobacco,  with  ten  grains 
of  opium  mixed  with  the  tobacco,  was  ufed,  but  without  effect 
the  two  firfl  times  on  account  of  the  imperfection  of  the  machine ; 
on  the  third  time  it  produced  great  ficknefs,  and  vertigo,  and  nearly 
a.  fainting  fit  ;  from  which  time  the  blood  entirely  flopped. 
Was  this  owing  to  a  fungous  excrefcence  in  the  rectum  ;  or  to 
a  blood-veflel  being  burft  from  the  difficulty  of  the  blood  pafTing 
through  the  vena  porta  from  fome  hepatic  obftruction,  and 
which  had  continued  to  bleed  fo  long  ?  Was  it  flopped  at  laft 
by  the  fainting  fit  ?  or  by  the  flimulus  of  the  tobacco  ? 

7.  Hxmorrhagiarenum.    Hemorrhage  from  the  kidneys,  when 
attended  with  no  pain,  is  owing  to  defect  of  venous  abforption  in 

the 


5  6  DISEASES  CLASS!.  2.  i.  8. 

the  kidney.  When  attended  with  pain  on  motion,  it  is  owing 
to  a  bit  of  gravel  in  the  ureter  or  pelvis  of  the  kidney  ;  which  is 
a  much  more  frequent  difeaie  than  the  former.  See  Sect. 
XXVII.  i. 

M.  M.  i.  Venefe£Kon  in  fmall  quantity,  calomel,  bark,  fteel, 
an  opiate  ;  cold  immerfion  up  to  the  navel,  the  upper  part  of 
the  body  being  kept  clothed.  Neville-Holt  water.  2.  Alcali- 
xed  water  aerated.  Much  diluent  liquids.  Cool  drefs.  Cool 
bed-room. 

Cows  ate  much  fuhject  to  bloody  urine,  called  foul  water  by 
the  farmers  ;  in  this  difeafe  about  fixty  grains  of  opium  with  or 
without  as  much  ruft  of  iron,  given  twice  a  day,  in  a  ball  mixed 
with  flour  ahd  water,  or  difTolved  in  warm  water,  or  warm  ale, 
are,  I  believe,  an  efficacious  remedy,  to  which  however  mould  be 
added  about  two  quarts  of  barley  or  oats  twice  a  day,  and  a  cover 
at  night,  if  the  weather  be  cold. 

8.  H&morrhagia  hepatis.  Haemorrhage  from  the  liver.  It 
fometimes  happens  in  thofe,  who  have  the  gutta  rofea,  or  para- 
lytic affections  owing  to.difeafed  livers  induced  by  the  potation 
of  fermented  liquors,  that  a  great  difcharge  of  black  vifcid  blood 
occaflonally  comes  away  by  ftool,  and  fometimes  by  vomiting : 
this  the  ancients  called  melancholia,  black  bile.  If  it  was  bile,  a 
fmall  quantity  of  it  would  become  yellow  or  green  on  dilution 
with  warm  water,  which  was  not  the  cafe  in  one  experiment 
which  I  tried  ;  it  muft  remain  fome  time  in  the  interlines  from 
its  black  colour,  when  it  pafles  downwards,  and  probably  comes 
from  the  bile-ducts,  and  is  often  a  fatal  fymptom.  When  it  is 
evacuated  by  vomiting  it  is  lefs  dangerous,  becaufe  it  (hews  great- 
er remaining  irritability  of  the  inteftinal  canal,  and  is  fomerimes 
falutary  to  thofe  who  have  difeafed  livers. 

Two  elderly  men,  who  had  loft  their  appetite  for  animal  food, 
which  is  always  a  dangerous  fymptom,  when  it  occurs  to  ,:hofe 
who  have  drank  too  much  fermented  liquor,  obferved,  that  they 
parted  with  black  ftools.  One  of  them  alfo  had  the  mucus  of 
his  noftrils  occaiionally  ftained  with  blood.  The  black  ftools 
appeared  evidently  to  confift  of  the  coagulum  of  blood,  fome- 
times without  other  feces.  After  a  few  weeks>  they  both  funk 
under  this  difcharge,  which  I  fuppofed  to  proceed  from  the  liv- 
er, as  it  never  appeared  florid  in  any  part  of  it.  See  Section 
XXVII.  2. 

M.  M.  An  emetic.     Rhubarb,  fteel,  wine,  bark,  opium. 

9.  Hamoptoe  venofa.  Venous  hsemoptoe  frequently  attends 
the  beginning  of  the  hereditary  confumptions  of  dark-eyed  peo- 
pie  ;  and  in  others,  whofe  lungs  have  too  little  irritability.  Thefe 
fpittings  of  blood  ave  generally  in  very  frmli  quantity,  as  a  tea- 

fpoonful ;.  - 


CLASS  1. 2.  T.  10.          OF  IRRITATION.  57 

fpoonful  ;  and    return    at   fir  (I   periodically,   as    about  once   a 
month  ;  and  are  lefs  dangerous  in  the  female  than   in   the  male 
fox  ;  as  in  the  former  they  are  often  relieved  by  the  natural  pe- 
riods of  the  menfcs.     Many  of  thefe  patients  are  attacked   with 
this  pulmonary  haemorrhage  in  their  nrft  deep  ;  becaufc  in 
ble  people  the  power  of  volition  is  neceiiary,  befides  that  01" 
tation,  to  carry  on  refpiration  perfectly  •,  but,  as  volition   is  iul- 
pended  during  fleep,  a  part  of  the   blood  is  delayed   in  the 
fels  of  the  lungs,  and   in  conlequence   effufed,  and  the  pa: 
awakes  from  the   diiagreeable    fenfation.      See  Clais  I.  2.  i.  3. 
II.  1.6.6.     III.  2.  i.  10.  and  Sea.  XXVII.  2. 

M.  M.  Wake  the  patient  every  two  or  three  hours  by  an 
alarum  clock.  Give  half  a  grain  of  opium  at  going  to  bed,  or 
twice  a  day.  Onions,  garlic,  flight  chalybeates.  Ifiues.  Lee 
applied  once  a  fortnight  or  month  to  the  hemorrlicidal  vein:?  to 
pro'duce  a  new  habit.  Emetrcs  after  each  period  of  hsemoptoe, 
to  promote  expectoration,  and  difiodge  any  effufed  blood,  which 
might  by  remaining  in  the  lungs  produce  ulcers  by  its  putridity. 
A  hard  bed,  to  prevent  too  found  fleep.  A  periodical  emetic  or 
cathartic  once  a  fortnight. 

10.  Pdlpitatio  cordls.  The  palpitation  of  the  heart  frequently 
attends  the  hx  map  toe  above  mentioned  ;  and  conilils  in  an  in- 
effectual exertion  of  the  heart  to  pufh  forwards  its  contents  in 
due  time,  and  with  due  force.  The  remote  caufe  is  iVcquently 
ibme  impediment  to  the  general  circulation  ;  as  the  torpor  of 
the  capillaries  in  cold  paroxyfms  of  fever,  or  great  adhehons  oi" 
the  lungs.  At  other  times  it  -.-in  the  debility  of  the  action 

of  the  heart  owing  to  the  deficient  icmbrial  power  ^L  irnLaiion 
or  of  affociation,  as  at  the  approach  of  death. 

In  both  thefe  cai  i  the  heart  feels  large  to  the 

touch,  as  it  does  not  completely  empty  itfelf  at  each  contraction  j 
and  on  that  account  contracts  more   frequently,  as  defcribed  in 
Sect.  XXXII.  2.  2.      Another  kind  of  palpitation  may  fome. 
arife  from  the  retrograde  motions  oi"  the  heart,  as  in  fear.      SLV 
Clafsl,  3.  i.  2.  and  IV.  3.  i.  6. 

n.  Menorrhagia.  Continued  flow  of  the  catamenia.  Ths 
monthly  effufion  of  blood  from  the  uterus  or  vagina  is  owin^  to 
a  torpor  of  th~  f  thofe  membranes  in  coniequci, 

defecl;  of  venereal  ftimulus  -,  and  in  this  refpect    refeai  ^ 
mucus  difcharged  in  the  periodical  venereal orgaftn  -  nale? 

quadrupeds,  which  are  fecluded  from  the  males.  Tiic  menor* 
rhagia,  or  continued  flow  of  this  difcharge,  is  owing  to  a  con- 
tinued defecl:  of  the  venous  abforption  of  the  membranes  of  the 
uterus  or  vagina.  See  Clafs  IV.  2.  4.  7. 

M.  M.  Vencficliou  in  (mall  cuant-tv.     A  cathartic.     Then 

VOL.  II  I  onmm 


5$  DISEASES  CLASS  1.  2.  *.  12, 

opium,  a^rain^every  night.     Steel.     Bark.     A  Wider.     Topi- 
cal afperlion  with  cold  water,  or  cold  vinegar. 

One  caufe  of  exceffive  menflruation,  which  fometimes  recurs 
monthly,  and  continues  for  a  fortnight  at  each  period,  and  is 
fucceedecl  by  fiuor  albus  during  the  intervals,  I  have  fufpec~led  to 
arife,  like  the  bleeding  piles,  from  enlargement  of  the  liver,  which 
is  liable  to  occur  about  the  age  of  forty  to  thole  who  have  drank 
much  flrong  fmall  beer,  or  wine  5  or  to  thofe  who  have  unfor- 
tunately been  long  accuflomed  to  the  ufe  of  tight  flays,  or  other 
bandages  round  their  bowels.  In  thefe  fituations  6  or  8  grains  of 
rhubarb  mould  be  taken  every  night  for  months,  or  even  years. 
Calomel,  4  or  6  grains  mould  be  taken  as  a  cathartic  one  a  month. 
A  flannel  drefs  on  the  legs,  thighs,  and  lower  body  may  be  ufe- 
ful  in  the  cold  feafon,  but  injurious  in  the  warmer  months. 
Weak  acid  of  vitriol  ten  drops,  two  or  three  times  a  day  ;  fleel 
in  very  fmall  quantity  ;  and  a  very  loofe  drefs  round  the  body  -y 
are  recommended. 

12.  Dyfmenorrhagia.     A  difficulty  of  menftruation   attended 
with  pain.      In  this  complaint  the  torpor  of  the  uterine  vefTels, 
which  precedes  menflruation,  is  by  fympathy  accompanied  with 
a  torpor  of  the  lumbar  membranes,  and  confequent  pain  ;  and 
frequently   with  cold   extremities,   and  general  debility.     The 
fmall  quantity  and  difficulty  of  the  difcharge  is  owing  to  arterial 
inactivity,  as  in  chlorofis.     Whence  it  happens,  that  chalybeate 
medicines  are  of  efficacy  both  to  flop  or  prevent  too  great  men- 
ftruation, and  to  promote  or    increafe    deficient  menflruation  ; 
as  the  former  is  owing  to  inirritability  of  the  veins,  and  the  lat- 
ter of  the  arteries  of  the  uterus.    See  Article  IV.  2.  6.  in  the  Ma- 
teria'Medica. 

M.  M.  Opium,  fleel,  pediluvium.     Warm  bath. 

13.  Lcchia  nimla.  Too  great  difcharge  after  delivery.     In  that 
unnatural  practice  of  fomehafty  accoucheurs  of  introducing  the 
hand  into  the  uterus  immediately  after  the  delivery  of  the  child, 
and  forcibly  bringing  away  the  placenta,  it  frequently  happens, 
that  a  part  of  it  is  left  behind  ;  and  the  uterus,  not  having  pow- 
er to  exclude   fo  fmall  a  portion  of  it,  is  prevented  from  com- 
plete contraction,  and  a  great  haemorrhage  enfues.     In  this  cir- 
cumflance  a  bandage  with  a  thick  comprefs  on  the  lower  part  of 
the  belly,  by  appreffirig  the  fides  of  the  uterus  on  the  remaining 
part  of  the  placenta,  is  likely  to  check  the  haemorrhage,  like  the 
application  of  a  pledget  of  any  foft  fubilance  on  a  bleeding  veflcl. 

In  o'.her  cafes  the  lochia  continues  too  long,  or  in  too  great 
quantity,  owing  to  the  deficiency  of  venous  abforption. 

M.  M.  An  enema.  An  opiate.  Ablifter.  Slight  calybe- 
ates.  Peruvian  bark.  Cloths  dipped  in  cold  vinegar  and  applied 

externally. 


CLASS  I.  2.  i.  14-    OF  IRRITATION.  59 

externally.     Bandages  on  the  limbs  to  keep  more  blood  in  them 
for  a  time  have  been  recommended. 

14.  Abortlo  Spontanea.     Some  delicate  ladies   are  perpetual1.-; 
liable  to  fpontaneous  abortion,  before  the  third,  or  after  the  lev- 
enrh,  month  of  geitation.     From  tome  of  thefe  patients  I  have 
learnt,  that  they  have  awakened  with  a  flight  degree  of  dip 
refpiration,  fo  as  to  induce  them  to  rife  haitily  up  in  bed  5   and 
have  hence  fufpedted,  that  this  was  a  tendency  to  a  kii- 
ma,  owing  to  a  deficient  abforption  of  blood  in  ti 
of  the  pulmonary  or  bronchial  veins  ;   and  have  conclu 
thence,  that  there  was  generally  a  deficiency   of  venous  abforp- 
tion ;  and  that  this  was  the  occasion  of  their  frequent  abortion. 
Which  is  further  countenanced,  where  a  great  fanjjuinary  dif- 
charge  precedes  or  follows  the  exclufion  of  the  fetus. 

Mifcarriages  are  fometimes  induced  by  what  is  termed  a  re- 
troverfion  of  the  uterus,  in  which  the  fundus  uteri  is  retrov 
and  prefled  down  between  the  rectum  and  the   vagina. 
can  only  occur  in  the  fir  ft  or  fecond  month  of  geitation,  and  is 
generally  preceded  by  a  difficulty  of  making  water,  and  a  confe- 
quent  tumour  of  the  bladder  ;  a  violent  pain  about  the  per'uueum 
or  rectum  is  thus  caufed,  and  a  mifcarriage    is  liable  to  follow. 
Draw  off  the  urine  with  a  catheter;  inject  an  enema  with  fixty 
drops  of  tincture  of  opium,  if  it  can  be  done.     If  it  recurs  fre- 
quently after  the  mifcarriage,  a  wax  candle,  or  a  peiTary,  made 
by  rolling  fome  emplaftrum  de   minio  fpread  on  linen,  may  be 
introduced  into  the  rectum,  and  worn  as  a  comprefs  to 
vent  the  return  for  a  few  days,  till  the  parts  recover  their  ftrengtru 
See  London  Medical  Obfervations,  Vol.  IV.  p.    388.  and  Dr. 
Hunter's  Tables  of  the  Gravid  Uterus. 

M.  M.  Opium,  bark,  chalybeates  in  fmall  quantity.  Change 
to  a  warmer  climate.  I  have  directed  with  fuccefs  in  four  cafes 
half  a  grain  of  opium  twice  a  day  for  a  fortnight,  and  then  a 
whole  grain  twice  a  day  during  the  whole  geftation.  One  of 
thefe  patients  took  befides  twenty  grains  of  Peruvian  bark  for 
feveral  weeks.  By  thefe  means  being  exactly  and  regularly  per- 
lifted  in,  a  new  habit  became  eitablilhed,  and  the  ufual  mifcar- 
riages  were  prevented. 

Mifcarriages  more  frequently  happen  from  eruptive  fevers,  and 
from  rheumatic  ones,  than  from  other  inflammatory  difeafes.  I 
faw  a  moft  violent  pleurify  and  hepatitis  cured  by  repeated  vene- 
fection  about  a  week  or  ten  days  before  parturition  ;  yet  another 
lady  whom  I  attended,  mifcarried  at  the  end  of  the  chicken  pox, 
with  which  her  children  were  at  the  fame  time  affected.  Mifcarri- 
ages towards  the  termination  of  the  fmall-pox  are  very  frequent, 
yet  there  have  been  a  few  inll-mces  of  children,  who  have  been 

barn 


£»  DISEASES  GtAssI.  2.  i.  is. 

born  with  the  eruption  on  them.  The  blood  in  the  fmall  pox  will 
not  inoculate  that  difeafe,  if  taken  before  the  commencement  of 
the  fecondary  fever  ;  as  fhewn  in  Sect.  XXXIII.  2.  10.  becaufe 
the  contagious  matter  is  not  yet  formed,  but  after  it  has  been 
oxygenated  through  the  cuticle  in  the  puftules,  it  becomes  con- 
tagious ;  and  if  it  be  then  abforbed,  as  in  the  fecondary  fever, 
the  blood  of  the  mother  may  become  contagious,  and  in  feel:  the 
child.  The  fame  mode  of  reafoning  is  applicable  to  the  chicken 
pox,  See  CJafsIV.  3.  i.  7. 

15.  Scorbutus.  S.ea-fcurvy  is  ca.ufed  by  fait  diet,  the  perpet- 
ual itimulus  of  which  debilitates  the  venous  and  abforbent  fyf- 
tems  ;  and  may  alfo  be  promoted  by  the  fea-air,  which  is  known 
to  be  fo  injurious  to  moft  vegetables,  which  grow  near  the  coafts, 
and  has  been  perhaps  incaurioufly  recommended  to  confumptive 
patients.  See  Clafs  II-.  i.  6.  7.  Hence  the  blood  is  imperfect- 
ly taken  up  by  the  veins  from  the  capillaries,  whence  browi* 
and  black  fpots  appear  upon  the  Jkin  without  fever.  The  limbs 
become  livid  and  edematous,  and  laftly  ulcers  are  produced  from 
deficient abforption.  See  Sect.  XXXIII.  3.  2.  and  Clafs  II.  i. 
4.  13.  For  an  account  of  the  fcurvy  of  the  lungs,  fee  Seel. 
XXVII.  2. 

M.  M.  Frefli  animal  and   vegetable  food.     Infufion  of  malt. 
New  beer.    Sugar.  Wine.  Steel.    Bark.  Sorbentia,  Opium  ? 

1 6.  Vibices.     Extravafations  of  blood  become  black  from  their 
being  fecluded  from  the   air.      The   extravafation    of  blood   in 
bruifes,  or  in  fome  fevers,  or  after  death  in  fome  patients,  ef- 
pecially  in  the  parts   which  were   expofed  to  prerTure,  is   owing 
to  the  fine  terminations  of  the  veins  having  been  mechanically 
comprefled  fo  as  to   prevent  their  abforbing  the  blood  from  the 
capillaries,  or  to  their  inactivity  from  difeafe.     The  blood  when 
extravafated  undergoes  a  chemical  change  before  it  is  fufficient- 
ly  fluid  to  be  taken  up  by  the  lymphatic  abforbents,  and  in  that 
procefs  changes  its  colour  io  green  and  then  yellow. 

17.  Petechia.     Purple  fpots.     Thefe  attend  fevers  with  great 
venous  inirritability,  and  are  probably  formed   by  the  inability 
of   a  fingle   termination  of  a  vein,    whence  the   correfponding 
capillary  becomes  ruptured,  and  effufes  the  blood  into  the  cellu- 
lar membrane  round  the  inert  termination  of  the  vein.     This  is 
generally  efteemed  a  fjgn  of  the  putrid  (late  of  the  blood,  or  that 
ilate  contrary  to  the  inflammatory  one.     As  it  attends  fome  in- 
flammatory difeafes  which  are  attended  with  great  inirritability, 
as  in  the  confluent  fmall  pox.     But  it  alfo  attends  the  fcurvy, 
where  no  fever  exifts,  and  it  therefore  {imply  announces  the.  in- 
activity of  the  terminations  of  fome  veins  5  and  is  thence  int. 

a  bad  fymptom  in  fevers,  as  a  mark  of  approaching  inactivity  of 


: 


I.  2.  i.  1 8.  '    OF  IRRITATION.  61 

the  whole  fanguiferous  fyftem,  or  death.  The  blue  colour  of 
fome  children's  arms  or  faces  in  very  cold  weather  is  owing  in 
manner  to  the  torpor  of  the  abforbent  terminations  of  the 
the  veins,  whence  the  blood  is  accumulated  in  them,  and  fome- 
times  burfis  them.  See  Hsemorrhagia  venofa,  and Suppl.  i.  2.  7. 

In  forne  cafes  of  fever  attended  with  petechise,  Dr.  HalJ,  of 
Colcheil'er,  directed  the  body  to  be  warned  with  cold  vinegar  and 
water  twice  a  day,  with  great  advantage.  The  petechise  became 
aily  lefs  numerous  and  lefs  livid,  the  pulfe  flower  and  ftrong- 
r,  with  lefs  delirium,  and  more  fieep.  'He  has  treated  twenty 
cafes  in  this  manner,  and  not  loft  one.  JVledical  Review,  Vol. 
III.  p.  8. 

In  thefe  cafes  not  only  the  application  of  external  cold  feems 
to  have  been  of  iervice,  by  preventing  the  unneceiTary  expendi- 
ture of  animal  power  ;  but  as  the  flimulus  of  vinegar  renders 
the  lips  pale,  when  applied  externally,  and  in  confequence  ftim- 
ulates  the  terminations  of  the  veins  into  greater  action  j  it  feems 
alfo  to  have  contributed  to  remove  the  Petechise. 

1 8.  Aneurifma.     Arreurifm  is  probably  owing  to  the  want  of 
due  irritability  of  a  part  of  the  coat  of  an  artery.     As  living 
raufclesare  known  to  refift  diruption  more  than  dead  ones,  ac- 
cording to  the  experiments  (I  think)  of  Dr.  Langrifh,  it  follows 
that  when  a  part  of  the  coat  of  an  artery  ceafes  to  contract  by 
the  (limulusof  the  blood,  that  it  will  foon  become  diftended   by 
the  force  of  it,  till  it  widens  into  a  fack,  and  at  laft  becomes 
ruptured. 

M.  M.  Venefedion  repeatedly  in  fmall  quantities.  Reft. 
Diluent,  mild  nutriment.  Daily  evacuation  by  a  pill  confifting 
of  rhubarb  eight  grains,  and  foap  four  grains. 

It  is  poflible  alfo,  that  an  aneurifrn  may  be  produced  by  the 
reliftance  to  the  circulation,  and  the  force  of  the  heart  being 
greater  than  the  fides  of  the  arteries  can  counterbalance. 

Mr.  Gimbernat  is  faid  to  have  cured  fome  cafes  of  aneurifm 
in  the  popliteal  artery  by  comprefTmg  it  by  means  of  an  adapted 
machine,  confifting  of  a  fteel  ring  above  and  below  the  knee, 
which  are  joined  by  a  plate,  beneath  which  is  placed  a  proper 
cufhion,  which  can  be  preffed  on  the  diftended  part  of  the  arte- 
ry more  or  lefs  by  of  means  a  fcrew.  The  other  method  of  cure 
is  by  a  double  ligature  above  the  aneurifm,  as  firft  pra&ifed  by 
Mr.  J.  Hunter. 

19.  Varlx.     The  varix  of  veins  occurs  frequently  in  the  legs 
of  women,  poflibly  fometimes  from  tight  garters,  and  has  for  its 
proximate  caufe  the  inirritability  of  the  coat  of  the  vein  ;  whence 
it  becomes  diibnded,  till  it  burits,  by  the  power  with  which  the 

blood 


62  DISEASES  CLASS  1. 2.  i. 

blood  is  thrown  into  it  by  the  abforbent  mouths,  which  take  it 
up  from  the  capillary  arteries. 

M.  M.  Tie  the  vena  faphena  below  the  joint  of  the  knee,  and 
the  blood  will  then  circulate  by  the  internal  veins  ;  and  that  flop- 
ped in  the  veins  beneath  the  ligature  will  be  abforbed. 

The  piles  may  be  termed  varixes,  and  may  be  deftroyed  by 
ex'Cifion  or  ligature.  See  Haemorrhois, 


i 


ORDO 


ss  I.  2.  2.  i.         OF  IRRITATION. 


ORDO  II. 

Decreafed  Irritation. 
GENUS  if. 

Decreafed  Aclion  of  the  Secerning 

j 

THESE  are  always  attended  with  decreafe  of  partial,  or  of  gen- 
1  heat  •,  for  as  the  heat  of  animal  bodies  is   the  confequence 
f  their  various  fecretions,  and  is  perpetually  paffing  away  into 
e  ambient  air,  or  other  bodies  in   contact  with   them  ;  when 
thefe  fecretions  become  diminimed,  or  ceafe,  the  heat  of  the  part 
or  of  the  whole  is  foon  diminimed,  or  ceafes  along  with  them. 

SPECIES. 

i.  Frigtts  febrile.  Febrile  coldnefs.  There  is  reafon  to  be- 
lieve, that  the  beginning  of  many  fever-fits  originates  in  the  qui- 
efcence  of  fome  part  of  the  abforbent  fyftem,  efpecially  where 
they  have  been  owing  to  external  cold  ;  but  that,  where  the 
coldnefs  of  the  body  is  not  owing  to  a  diminution  of  external 
heat,  it  arifes  from  the  inaction  of  fome  part  of  the  fecerning 
fyftem.  Hence  fome  parts  of  the  body  are  hot  whiht  other 
parts  are  cold  ;  which  I  fuppofe  gave  occafion  to  error  in  Mar- 
tyn's  Experiments  ;  where  he  fays,  that  the  body  is  as  hot  in  the 
cold  paroxyfms  of  fevers  as  at  other  times. 

After  the  fenforial  power  has  been  much  diminimed  by  great 
preceding  activity  of  the  fyftem,  as  by  long  continued  external 
heat,  or  violent  exercife,  a  fudden  expofureto  much  cold  produ- 
ces a  torpor  both  greater  in  degree  and  over  a  greater  portion  of 
the  fyftem,  by  fubtracting  their  accuftorned  ftimulus  from  parts 
already  much  deprived  of  their  irritability.  Dr.  Franklin  in  a 
letter  to  M.  Duberge,  the  French  tranfiator  of  his  works,  men- 
tions an  inftance  of  four  young  men,  who  bathed  in  a  cold 
fpring  after  a  day's  harveft  work  ;  of  whom  two  died  on  the 
fpot,  a  third  on  the  next  morning,  and  the  other  furvived  with 
difficulty.  Hence  it  would  appear,  that  thofe,  who  have  to  trav- 
el in  intenfely  cold  weather,  will  fooner  periih,  who  have  pre- 
vioully  heated  themfclves  much  with  drams,  than  thofe  who 
have  only  the  llirnulus  of  natural  food  ;  of  which  I  have  heard 
well  attefted  inftance.  See  Article  VII.  2.3.  Clafs  IIL 
z.  i.  i  7. 

Frzguj  chromcum.  Permanent  coldnefs.  Coldnafs  of  the  ex- 
tremities, 


64  DISEASES  GLASS  L  2. 2. 

tremities,  without  fever,  with  dry  pale  (kin,  is  a  fymptom  of 
general  debility,  owing  to  the  decreased  aftion  of  the  arterial 
lyilem,  and  of  the  capillary  veiiels  ;  whence  the  perfpirable 
matter  is  fecreted  in  lefe  quantity,  2nd  in  confequerice  the  fkin  is 
lefs  warm.  This  coldnefs»is  obfervable  at  the  extremities  oi 
limbs,  ears,  and  nofe,  more  than  in  any  other  parts  :  as  a  larger 
furface  is  here  expofed  to  the  contact  of  the  air,  or  clothes,  and 
thence  the  heat  is  more  haftily  carried  away. 

The  pain,  which  accompanies  the  coldnefs  of  the  fkin,  is 
owing  to  the  deficient  exertion  of  the  fubcutaneous  veffels,  and 
probably  to  the  accumulation  of  fenforial  power  in  the  extremi- 
ties of  their  nerves.  See  Sutl.  XII.  5.  3.  XIV.  6.  XXXII.  3. 
and  Clafs  I.  2.  4.  I. 

M.  M.  A  blifter.  Incitantia,  nutrientia,  forbentia.  Exey- 
cife.  Clothes.  Fire.  Joy.  Anger. 

2.  Pallor  fugitiv us.     The  fugitive  palenefs,  which  accompa- 
nies the  coldnefs  of  the  extremities',  is  owing  to  a  lefs  quantity 
of  blood  pafling  through  the  capillaries  of  the  (kin   in  a  given 
time  ;  where  the  abforbent   power  of  the  veins  is  at  the  fame 
time  much  diminished,  a  part  of  the  blood  lingers  at  their  June-; 
tion  with  the  capillary  arteries,  and  a  bluifh  tinge  is  mixed  with 
true  palenefs  ;  as  is  feen  in  the  loofe  fkin  under  the  eye-lids,  and 
is  always  a  mark  of  temporary  debility.     See  Clafs   II.  i.  4.  4. 
Where  the  palenefs  of  the  ikin  is  owing  'to  the  deficiency  of  red 
globules  in  the  blood,  it  is  joined  with  a  yellowim  tinge  -,  which 
is  the  colour  of  the  ferum,  with  which  the  blood  then  abounds, 
as  in  chlorofis,  and  in  torpor  or  paralyfis  of  the  liver,  and  is  of- 
ten miftaken  for  a  fuperabundance  of  bile. 

A  permanent  palenefs  of  the  Ikin  is  owing  to  the  coalefcence 
of  the  minute  arteries,  as  in  old  age.  See  Clafs  I.  2.  2.  9. 
There  is  another  fource  of  palenefs  from  the  increafed  abforption 
of  the  terminations  of  the  veins,  as  when  vinegar  is  applied  to  the 
lips.  See  Seel:.  XXVII.  i.  and  another  from  the  retrograde 
motions  of  the  capillaries  and  fine  extremities  of  the  arteries. 
See  Clafs  II.  3.  i.  i. 

M.  M.   A  blifter,  nutrientia,  incitantia,  cxercife,  oxygene  gas. 

3.  Pus  par  cms.     Diminimed   pus.     Drynefs   of  ulcers.     In 
the  cold  fits  of  fever  all  the  fecretions  are  diminiihed,  whether 
natural  or  artificials  as  their  quantity  depends  on  the  actions  of 
the  glands  or  capillaries,  which  then  (hare  in  the  univerfal  inac- 
tion of  the  fyftem.     Hence  the  drynefs  of  iflues  and  blilters  in 
great  debility,  and  before  the  approach  of  death,  is  owing  to  de- 
ficient fecretion,  and  not  to  increafed  abforptiou. 

M.  M.  Opium,  wine  in  very  fmall  quantities,  Peruvian  bark. 
4-  Mucus    parcior.     Dinimilhed    mucus.     Drynefs    of  the 

mouth 


CLASS  I.  2.  2.  5-       OF  IRRITATION.  65 

mouth  and  noftrils.  This  alfo  occurs  in  the  cold  fits  of  interrait- 
tents.  In  thefe  cafes  I  have  alfo  found  the  tongue  cold  to  the 
touch  of  the  finger,  and  the  breath  to  the  back  of  one's  hand, 
when  oppofed  to  it*  which  are  very  inaufpicious  fymptoms,  and 
generally  fatal.  In  fevers  with  inirritability  it  is  generally  el- 
teemed  a  good  fymptom,  when  the  noftrils  and  tongue  become 
moid  after  having  been  previoufly  dry  •,  as  it  (hews  an  increafed 
aftion  of  the  mucous  glands  of  thofe  membranes,  which  were  be- 
fore torpid.  And  the  contrary  to  this  is  the  fades  Hippocr.uica, 
or  countenance  fo  well  delcribed  by  Hippocrates,  which  is  pale, 
cold,  and  ihrunk  ;  all  which  are  owing  to  the  inactivity  oi:  the 
fecerning  vefiels,the  palenels  from  there  being  lefs  red  blood  pail- 
ing  through  the  capillaries,  the  coldnefs  of  the  fkin  from  there 
being  lefs  fecretion  of  perfpirable  matter,  and  the  ihrunk  appear- 
ance from  there  being  lefs  mucus  fecreted  into  the  cells  of  the 
cellular  membrane.  See  Glafs  IV.  2.  4.  1 1. 
M.  M.  Blifters.  Incitantia. 

5.  Ur'ina  parcior  pallida.     Paucity  of  pale  urine,  as  in  the  cold 
fits  of  intermittents  ;  it  appears  in  fome  nervous  fevers  through- 
out the  whole  difeafe,  and  feems  to  proceed  from  a  palfy  of  the 
kidneys  ;  which  probably  was  the  caufe  of  the  fever,  as  the  fever 
fometimes  ceafes,  when  that  fymptom  is  removed :  hence  the 
ftraw-coloured  urine  in  this  fever  is  fo  far  falutary,  as  it  (hews 
the  unimpaired  action  of  the  kidneys. 

M.  M.  Balfams,  eiTential  oil,  afparagus,  rhubarb,  a  blifter. 
Cantharides  internally. 

6.  Torpor  hepaticus.     Paucity  of  bile  from  a  partial  inaction 
of  the  liver  •,  hence  the   bombycinous  colour  of  the  fkin,  grey 
{tools,  urine  not  yellow,  indigeftion,  debility,  followed  by  tym- 
pany,  dropfy,  and  death. 

This  paralyfis  or  inirritability  of  the  liver  often  deftroys  thofe 
who  have  been  long  habituated  to  much  fermented  liquor,  and 
have  fuddenly  omitted  the  ufe  of  it.  It  allo  deitroys  plumbers 
and  houfe-painters,  and  in  them  feems  a  fubilitute  for  the  colica 
iaturnina.  See  Seel:.  XXX. 

M.  M.  Aloe  and  calomel,  then  the  bark,  and  chalybeates. 
Mercurial  ointment  rubbed  on  the  region  of  the  liver.  Rhubarb, 
three  or  four  grains,  with  opium  half  a  grain  to  a  grain  twice  a 
day.  Equitation,  warm  bath  for  half  an  hour  every  clay. 

7.  Torpor  pancreatis.     Torpor  of  the  pancreas.     I  law  what 
I  conjectured  to  be  a  tumour  of  the  pancreas  with  indigeilion, 
and  which  terminated  in  the  death  of  the  patient.     He  had  been 
for  many  years  a  great  confuiner  of  tobacco,  infomuch  that  he 
chewed  that  noxious  drug  all  the  morning,  and  fmoked  it  all  the 
afternoon.     As  the  fecretion  from  the  pancreas  refembles  iuliva 

VOL.  II,  K  in 


66  DISEASES  CLASS  I.  2.  2.  8* 

in  its  general  appearance,  and  probably  in  its  office  of  affifting  di- 
geftion,  by  preventing  the  fermentation  of  the  aliment ;  as  would 
appear  by  the  experiments  of  Pringle  and  Macbride  ;  there  is  rea- 
fon  to  fufpect,  that  a  fympathy  may  exifl  between  the  falivary 
and  pancreatic  glands  ;  and  that  the  perpetual  ftimulus  of  the 
former  by  tobacco  might  in  procefs  of  time  injure  the  latter. 
See  Tobacco,  Article  III.  2.  2. 

8.  Torpor  renis.  Inirritability  or  paralyfis    of  the   kidneys   is 
probably  frequently  miftaken  for  gravel  in  them.     Several,  whc» 
have  lived  rather  intemperately  in  refpect  to  fermented  or  fpir- 
ituous  liquors,  become  fuddenly  feized  about  the  age  of  fixty,  or 
later,  with  a  total  ftoppage  of  urine  ;  though  they  have  previ- 
oufly  had  no  fymptoms  of  gravel.     In  thefe  cafes  there  is  no- 
water  in  the  bladder ;  as  is  known  by  the  introduction  of  the 
catheter,  of  which  thofe  made  of  elaftic  gum  are  faid  to  be  pref- 
erable to  metallic  ones  •,   or  it  may  generally  be  known  by  the 
fhape  of  the  abdomen,  either  by  the  eye  or  hand.     Bougies  and' 
catheters  of  elaftic  gum  are   fold  at  No.  37,  Red  Lion-ftreet, 
Holborn,  London. 

Mk  M.  Electric  mocks,  warm  bath.  Emetics.  See  calcu- 
lus renis,  Clafs  I.  i.  3.  9.  When  no  gravel  has  been  previoufly 
obferved,  and  the  patient  has  been  a  wine-drinker  rather  than 
an  ale-drinker,  the  cafe  is  generally  owing  to  inirritability  of 
the  tubuli  uriniferi,  and  is  frequently  fatal.  See  Clafs  I.  2.  4.  20. 

9.  Punfta  muccfa  vultus.     Mucous  fpots  on  the  face.     Thefe 
are  owing  to  the  inactivity  of  the  excretory  ducts  of  the  mucous 
glands  ;  the  thinner  part  of  this  fecretion  exhales,  and  the  re- 
mainder becomes  infpiiTated,  and  lodges  in  the  duct  ;    the  ex- 
tremity of  which  becomes  black  by  expofure  to  the  air. 

M.  M.  They  may  be  prefled  out  by  the  finger-nails.  Warm 
water.  Ether  frequently  applied.  Blifter  on  the  part  ? 

10.  Macula  cuth  fulvx.     Morphew   or  freckles.     Tawny 
blotches  on  the  fkin  of  the  face  and  arms  of  elderly  people,  and 
frequently  on  their  legs  after  flight  eryfipelas.  The  freckles  on 
the  face  of  younger  people,  who  have  red  hair,  feem  to  be  a  fim- 
ilar  production,  and  feem  all  to  be  caufed  by  the  coalefcence  of 
the  minute  arteries  or  capillaries  of  the  part.     In  a  fear  after  a 
wound  the  integument  is  only  opaque ;   but  in  thefe  blotches, 
which  are  called  morphew  and    freckles,  the  fmall  veflels  feem 
to  have  become  inactive  with  fome  of  the  ferum  of  the  blood  ftag- 
nating  in  them,  from  whence  their  colour.  See  Clafs  III.  I.  2.  i 2. 

M.  M.     Warm  bathing.     A  blifter  on  the  part  ? 

11.  Canities.     Grey  hair.     In  the  injection  of  the  veflels  of 
animals  for  the  purpofes  of  anatomical  preparations,  the  colour 
of  the  injected  fluid  will  not  pafs  into  many  very  minute  veflels  ;. 

which 


CLASS  I.  2.  2,  1 1.        OF  IRRITATION.  67 

•which  neverthelefs  uncoloured  water,  or  fpirits,  or  quickfilvers 
will  permeate.  The  fame  occurs  in  the  filtration  of  fome  col- 
oured fluids  through  paper,  or  very  fine  fand,  where  the  colour- 
ing matter  is  not  perfectly  diflblved,  but  only  diffufed  through 
the  liquid.  This  has  led  fome  to  imagine,  that  the  caufe  of  the 
whitenefs  of  the  hair  in  elderly  people  may  arife  from  the  dimi- 
nution, or  greater  tenuity,  of  the  glandular  veffels,  which  fecrete 
the  mucus,  which  hardens  into  hair  ;  and  that  the  fame  differ- 
ence of  the  tenuity  of  the  fecerning  veflels  may  pofTibly  make  the 
difference  of  colour  of  the  filk  from  different  lilk- worms,  which 
is  of  all  (hades  from  yellow  to  white. 

•But  as  the  fecreted  fluids  are  not  the  confequence  of  mechan- 
ical filtration,  but  of  animal  felection  ;  we  muft  look  out  for 
another  caufe,  which  muft  be  found  in  the  decreafing  activity  of 
the  glands,  as  we  advance  in  life  ;  and  which  affects  many  of 
our  other  fecretions  as  well  as  that  of  the  mucus,  which  forms 
the  hair.  Hence  grey  hairs  are  produced  on  the  faces  of  horfes 
by  whatever  injures  the  glands  at  their  roots,  as  by  corrofive  blif- 
ters;  and  frequently  on  the  human  fubject  by  external  injuries 
on  the  head  ;  and  fometimes  by  fevers.  And  as  the  grey  col- 
our of  hair  confifts  in  its  want  of  tranfparency,  like  water  con- 
-verted  into  fnow  -,  there  is  reafon  to  fuppofe,  that  a  defect:  "of  fe- 
creted moifture  (imply  may  be  the  caufe  of  this  kind  of  opacity, 
as  explained  in  Cataracta,  Clafs  I.  2.  2.  13. 

M.  M.  Whatever  prevents  the  inirritability  and  infenfibility 
of  the  fyftem,  that  is,  whatever  prevents  the  approach  of  old  age> 
will  fo  far  counteract;  the  production  of  grey  hairs,  which  is  a 
fymptom  of  it.  For  this  purpofe  in  people,  who  are  not  corpu- 
lent, and  perhaps  in  thofe  who  are  fo,  the  warm  bath  twice  or 
thrice  a  week  is  particularly  ferviceable.  See  Sect.  XXXIX.  5. 
i.  on  the  colours  of  animals,  and  Clafs  I.  i.  2.  15. 

As  meohanical  injury  from  a  percuffion,  or  a  wound,  or  a  cauf- 
tic,  is  liable  to  occafion  the  hair  of  the  part  to  become  grey;  fo 
I  fufpect  the  compreffion  of  parts  againft  each  other  of  fome  an- 
imals in  the  womb  is  liable  to  render  the  hair  of  thofe  parts  of 
a  lighter  colour  ;  as  feems  often  to  occur  in  black  cats  and  dogs. 
A  fmall  terrier  bitch  now  (lands  by  me,  which  is  black  on  all 
thofe  parts,  which  were  external,  when  fhe  was  wrapped  up  in 
the  uterus,  teres  atque  rotunda  ;  and  thofe  parts  white,  which 
were  moft  conftantly  preffed  together  ;  and  thofe  parts  tawny, 
which  were  generally  but  lefs  conftantly  preffed  together.  Thus 
the  hair  of  the  back  from  the  forehead  to  the  end  of  the  tail  is 
black,  as  well  as  that  of  the  fides,  and  external  parts  of  the  legs, 
both  before  and  behind. 

As  in  the  uterus  the  chin  of  the  whelp  is  bent  down,  and  lies 


6$  DISEASES  CLASS  I.  2.  2.  if. 

in  contaft  with  the  fore  part  of  the  neck  and  bread  ;  the  tail  is 
applied  clofe  againft  the  divifion  of  the  thighs  behind  ;  the  infide 
of  the  hinder  thighs  are  preffed  clofe  to  the  fides  of  the  belly,  all 
thefe  parts  have  white  hairs. 

The  fore-legs  in  the  uterus  lie  on  each  fide  of  the  face  ;  fo 
that  the  feet  cover  part  of  the  temples,  and  comprefs  the  prom- 
inent part  of  the  upper  eye-brows,  but  are  fo  placed  as  to  defend 
the  eye-balls  from  preffure  ;  it  is  curious  to  obferve,  that  the 
hair  of  the  fides  of  the  face,  and  of  the  prominent  upper  eye- 
brows, are  tawny,  and  of  the  infide  of  the  feet  and  legs,  which 
covered  them  ;  for  as  this  pofture  admitted  of  more  change  in  the 
latter  weeks  of  geftation,  the  colour  of  thefe  parts  is  not  fo  far 
removed  from  black,  as  of  thofe  parts,  where  the  contacl  or 
compreflion  was  more  uniform. 

I  have  lately  alfo  infpecled  a  male  cat ;  who  is  quite  black  all 
over,except  thofe  parts  which  appear  to  have  been  folded  together 
in  the  uterus  ;  all  which  are  perfectly  white.  In  both  thefe  ani- 
mals the  parts  comprefTed  together  are  fo  diftinftly  defined  by 
their  colour,  that  the  difference  of  the  curvature  and  fituation 
of  them  in  the  uterus  may  be  nicely  difcerned  :  the  hinder  feet 
of  the  cat  lay  in  the  arm-pits  of  the  fore-legs,  and  are  white  ; 
her  fore-legs  croffed  over  the  hinder  thighs,  and  left  on  them  a 
white  mark  ;  but  the  fore-feet,  at  lead  the  hind  part  of  them, 
lav  under  the  tail ;  whence  the  fore-feet  are  tipped  with  white. 
Where  the  foetus  is  lefs  tender,  I  fuppofe,  this  compreflion  in 
the  uterus  does  not  affecT:  it  ;  as  (Jogs  and  cats  are  perpetually 
feen,  which  are  totally  black. 

Where  this  uterine  compreffion  of  parts  has  not  been  fo  great 
as  to  gender  the  hair  white  in  other  animals,  it  frequently  hap- 
pens, that  the  extremities  of  the  body  are  white,  as  the  feet, 
and  nofe,  and  tips  of  the  ears  of  dogs  and  cats  and  horfes,  where 
the  circulation  is  naturally  weaker  ;  whence  it  woukkfeem,  that 
the  capillary  glands,  which  form  the  hair,  are  impeded  in  the 
firfl  inftance  by  compreffion,  and  in  the  laft  by  the  debility  of 
the  circulation  in  them.  See  Glafs  I.  1.2.  15. 

This  day,  Auguft  8th,  1 794,  I  have  feen  a  negro,  who  was 
born  (as  he  reports)  of  black  parents,  both  father  and  mother,  at 
Kinglton  in  Jamaica,  who  has  many  large  white  blotches  on  the 
fkin  of  his  limbs  and  body  ;  which  I  thought  felt  not  fo  foft  to 
the  finger,  as  the  black  parts.  He  has  a  white  divergent  blaze 
from  the  fummit  of  his  nofe  to  the  vertex  of  his  head  ;  the  up- 
per part  of  which,  where  it  extends  on  the  hairy  fcalp,  has  thick 
curled  hair,  like  the  other  part  of  his  head,  but  quite  white.  By 
thefe  marks  I  fuppofed  him  to  be  the  fame  black,  who  is  defcri- 
bed,  when  only  two  years  old,  in  the  Tranfaclions  of  the  Ameri- 
can 


CLASS  I.  2.  2.  12.         OF  IRRITATION.  69 

can  Philofophical  Society,  Vol  II.  page  292,  where  a  female  one 
is  likewife  defcribed  with  nearly  fimilar  marks. 

The  joining  of  the  frontal  bones,  and  the  bregma,  having  been 
later  than  that  of  the  other  futures  of  the  cranium,  probably 
gave  caufe  to  the  whitenefs  of  the  hair  on  thcfe  parts  by  delaying 
or  impeding  its  growth. 

12.  Callus.  The  callous  (kin  on  the  hards  and  feet  of  laborious 
people  is  owing  to  the  extreme  vefTels  coalefcing  from  the  per- 
petual prefiure  they  are  expofed  to. 

As  we  advance  in  life,  the  finer  arteries  lofe  their  power  of 
aclion,  and  their  fides  grow  together ;  hence  the  palenefs  of  the 
ftins  of  elderly  people,  and  the  lots  of  that  bloom,  which  is  ow- 
ing to  the  numerous  line  arteries,  and  the  tranfparency  of  the 
|  flctn,  that  enciofes  them. 

M.  M.  Warm  bath.  Paring  the  thick  fkin  with  a  knife. 
Smoothing  it  with  a  pumice  (lone.  Cover  the  part  with  oiled 
filk  to  prevent  the  evaporation  of  the  perfpirable  matter,  and 
thus  to  keep  it  moid. 

13.  Catarafta  is  an  opacity  of  the  cryftalline  lens  of  the  eye. 
It  is  a  difeaie  of  light-coloured   eyes,  as  the  gutta    ferena  is  of 
dark  ones.      On  cutting  oft' with    fciflars  the  cornea  of  a  calf> 
eye,  and  holding  it  in  the  palm  of  one's  hand,  fo  as  to  gain  a  prop- 
er light,  the  artery,  which  fupplies   nutriment  to  the  cryftalline 
humour,  is  eafily  and  beautifully  feen  ;  as  it  rifes  from  the  cen- 
tre of  the  optic  nerve  through  the  vitreous  humour  to  the  cryf- 
talline.    It  is  this  point,  where  the  artery  enters  the  eye  through 
the  cineritious  part  of  the  optic  nerve,  (which  is  in  part  near  the 
middle  of  the   nerve,)  which  is  without   fenfibility  to  light  ;  as 
is  fhewn  by  fixing  three  papers,  each  of  them  about  half  an  inch 
in  diameter,  againft  a  wall  about  a  foot  diftant  from  each  other, 
about  the  height  of  the  eye  ;  and  then  looking  at  the  middle  one, 
with  one  eye,  and  retreating  till  you  lofe  fight  of  one  of  the  exter- 
nal papers.  Now  as  the  animal  grows  older,  the  artery  becomes  lefs 
vifible,  and  perhaps  carries  only  a  tranfparent  fluid,  and  atlengthin 
fome  fubjecls  I  fuppofe  ceafes  to  be  pervious  ;  then  it  follows,  that 
the  cryftalline  lens,  lofmg  fome  fluid,  and  gaining  none,  becomes 
dry,  and  in  confequence  opaque  ;  for  the  fame  reafon,  that  wet  or 
piled  paper  is  more  tranfparent  than  when  it  is  dry, as  explained  in 
Clafsl.  1.4.  i.  Thewantof  moifture  in  the  cornea  of  old  people, 
when  the  exhalation  becomes  greater  than  the  fupply,is  the  caufe 
of  its  want  of  tranfparency  ;  and  which  like  the  cryftalline  gains 
rather  a  milky  opacity.  The  fame  analogy  may  be  ufed  to  explain 
the  whitenefs  of  the  hair  of  old  people,  which  lofes  its  peliucidity 
along  with  its  moifture.     See  Clafs  I.  2.  2.  1 1. 

M.  M.  Small  electric  (hocks  through  the  eye.     A  quarter  of 

a 


7®  DISEASES  CLASS  I.  2.  2.  13; 

a  grain  of  corrofive  fublimate  of  mercury  difTolved  in  brandy,  or 
taken  in  a  pill,  twice  a  day  for  fix  weeks.  Couching  by  depref- 
fion,  or  by  extraction.  The  former  of  thefe  operations  is  much  to 
be  preferred  to  the  latter,  though  the  latter  is  at  this  time  fo 
fashionable,  that  a  furgeon  is  almoft  compelled  to  ufe  it,  left  he 
ihould  not  be  thought  an  expert  operator.  For  deprefiing  the 
Cataract  is  attended  with  no  pain,  no  danger,  no  confinement, 
and  may  be  as  readily  repeated,  if  the  cryftailine  fhouid  rife  again 
to  the  centre  of  the  eye.  The  extraction  of  the  cataract  is  at- 
tended with  confiderable  pain,  with  long  confinement,  generally 
with  fever,  always  with  inflammation,  and  frequently  with  irre- 
parable injury  to  the  iris,  and  confequent  danger  to  the  whole 
eye.  Yet  has  this  operation  of  extraction  been  trumpeted  into 
vmiverfal  fafhion  for  no  other  reafon  but  becaufe  it  is  difficult  to 
perform,  and  therefore  keeps  the  bufinefs  in  the  hands  of  a  few 
empirics,  who  receive  larger  rewards,  regardlefs  of  the  hazard, 
which  is  encountered  by  the  flattered  patient. 

A  friend  of  mine  .returned  yefterday  from  London  after  an 
abfence  of  many  weeks  5  he  had  a  cataract  in  a  proper  flate  for 
the  operation,  and  in  fpite  of  my  earned  exhortation  to  the  con- 
trary, was  prevailed  upon  to  have  it  extracted  rather  than  depreff- 
ed.  He  was  confined  to  his  bed  three  weeks  after  the  operation, 
and  is  now  returned  with  the  iris  adhering  on  one  fide  fo  as  to 
make  an  oblong  aperture  ;  and  which  is  nearly,  if  not  totally, 
without  contraction,  and  thus  greatly  impedes  the  little  vifion, 
which  he  poiTeffes.  Whereas  I  faw  fome  patients  couched  by 
depremon  many  years  ago  by  a  then  celebrated  empiric,  Cheva- 
lier Taylor,  who  were  not  confined  above  a  day  or  two,  that  the 
eye  might  gradually  be  accu domed  to  light,  and  who  faw  as  well 
as  by  extraction,  perhaps  better,  without  either  pain,  or  inflam- 
mation, or  any  hazard  of  lofing  the  eye. 

As  the  inflammation  of  the  iris  is  probably  owing  to  fdrcing 
the  cryftailine  through  the  aperture  of  it  in  the  operation  of  ex- 
.tracting  it,  could  it  not  be  done  more  fafely  by  making  the  open- 
ing behind  the  iris  and  ciliary  procefs  into  the  vitreous  humour  ? 
but  the  operation  would  ftill  be  more  painful,  more  dangerous> 
and  not  more  ufeful  than  that  by  deprefling  it. 

If  extraction  of  the  cryftailine  be  ufed,  Dr.  Reimarus  of  Ham- 
burgh advifes  to  drop  into  the  eye  previous  to  the  operation, 
fome  extract  of  belladonna  diflblved  in  water,  which  he  has  found 
to  produce  a  temporary  paralyfis  of  the  retina,  and  thence  a  total 
inaction  of  the  iris,  fo  that  it  remains  perfectly  expanded,  and 
is  thence  lefs  liable  to  be  injured  by  the  operation,  and  the  eye 
perhaps  lefs  liable  to  inflammation.  Might  not  this  be  of  advan- 
tage in  fome  ophthalmies  ? 

14.  InnutrltiQ 


CLASS 

14. 


bo 

• 


ASS  I.  2.  2.  14.         OF  IRRITATION.  71 

14.  Innutntio   offtum.      Innutrition  of  the  bones.     Not  only 
the  blood  effuled  in  vibices  and  petechise,  or  from  bruifes,  as  well 
as  the  blood  and  new  veffels  in  inflamed  parts,  are  reabforbed  by 
the  increafed  action  of  the  lymphatics  ;  but  the  harder  materials, 
which  conftitute  the  fangs  of  the  firft  fet  of  teeth,  and  the  ends 
of  exfoliating  bones,  and  fometimes  the   matter  of  chalk-ftones 
in  the  gout,   the  coagulable  lymph,  which  is  depofited  on  the 
lungs,  or  on  the  mufcles  after  inflammation  of  thofe  parts,  and 
which  frequently  produces  difficulty  of  breathing,  and  the  pains 
of  chronic  rheumatifm,  and  ladly  the  earthy    part  of  the  living 
bones  are  diffolved  and  abforbed  by  the  increaied  actions  of  this 
(tern  of  veffels.     See  Seel.  XXXIII.  3.1. 
The  earthy  part  of  bones  in   this  difeafe  of  the  nutrition  of 
em   feems  to  fuffer  a  folution,  and    reabforption ;  while  the 
veffels  do  net  fupply  a  fuflkient  quantity  of  calcareous 
earth  and  phofphoric  acid,  which  conftitute  the  fubita-nce  of  bones. 
As  calcareous  earth  abounds  every  \vhere,  is  the   want  of  phof- 
phoric acid  the   remote   caufe  ?     One  caufe  of  this  malady  is 
given  in  the  Philofophic  Tranfactions,  where  the    patient   had 
been  accuftomed  to  drink  large  quantities  of  vinegar.    Two  cafes 
are  defcribed  by  Mr.  Gouch.     In  one  cafe,  which  I  faw,  a  con- 
fiderable  quantity  of  calcareous  earth*  and  afterwards  of  bone- 
aflies,  and  of  decoction  of  madded,  and  alfo  of  fublimate  of 
mercury,  were  given  without  effect.     All  the  bones  became  foft, 
many  of  them  broke,  and  the  patient  feemed  to  die  from   the 
want  of  being  able  to  diftend  her  cheft  owing  to  the  foftnefs  of 
the  ribs. 

M.  M.  Salt  of  urine,  called  fal  microcofmicum,  phofphorated 
foda.  Calcined  hartfhorn.  Bone-afhes.  Hard  or  petrifying 
water,  as  that  of  Matlock,  or  fuch  as  is  found  in  all  limeftone 
or  marly  countries.  The  calcareous  earth  in  thefe  waters  might 
poffibly  be  carried  to  the  bones,  as  madder  is  known  to  colour 
them.  Warm  bath.  Volatile  or  fixed  alkali  as  a  lotion  on  the 
fpine,  or  effential  oils. 

The  innutrition  of  the  bones  is  often  firft  to  be  perceived  by 
the  difficulty  of  breathing  and  palpitation  of  the  heart  on  walking 
a  little  fafter  thanufual,  which  I  fuppofe  is  owing  to  the  foft- 
nefs  of  the  ends  of  the  ribs  adjoining  to  the  fternum  j  on  which 
account  they  do  not  perfectly  diften-d  the  cheft,  when  they  are 
raifed  by  the  pectoral  and  intercoftal  mufcles  with  greater  force 
than  ufual.  After  this  the  fpine  becomes  curved  both  by  the 
foftnefs  of  its  vertebrae,  and  for  the  purpofe  of  making  room  for 
the  difturbed  heart.  See  Species  16  of  this  Genus. 

As  thefe  patients  are  pale  and  weak,  there  would  feem  to  be 
deficiency  of  oxygene  in  their  blood,  and  in  confequence  a  defi- 
ciency 


72  DISEASES  CLASS  I.  2.  z-  14. 

ciency  o£  phofphoric  acid  ;  which  is  probably  produced  by  ox- 
ygene  in  the  act  of  refpiration. 

Mr.  Bonhome,  in  the  Chemical  Annals,  Auguft,  1 793,  fup- 
pofes  the  rickets  to  arife  from  the  prevalence  of  vegetable  or 
acetous  acid,  which  is  known  to  fofien  bones  out  of  the  body. 
Mr.  Dettaen  feems  to  have  efpoufed  a  fimilar  opinion,  and  both 
of  them  in  confequence  give  alkalies  and  teftacea.  If  this  the- 
ory was  juft,  the  foft  bones  of  fuch  patients  mould  (hew  evident 
marks  of  fuch  acidity  after  death ;  which  I  believe  has  not  been 
obferved.  Nor  is  it  analogous  to  other  animal  facts,  that  nu- 
tritious fluids  fecreted  by  the  fined  veflels  of  the  body  fiiould  be 
fo  little  animalized,  as  to  retain  acetous  or  vegetable  acidity. 

The  fuccefs  attending  the  following  cafe  in  fo  fhort  a  time  as 
a  fortnight  I  afcribed  principally  to  the  ufe  of  the  warm  bath  ; 
in  which  the  patient  continued  for  full  half  an  hour  every  night, 
in  the  degree  of  heat,  which  was  mofl  grateful  to  her  fenfation, 

which  might  be  I  fuppofe  about  94.  Mifs ,  about  ten  years 

of  age,  and  very  tall  and  thin,  has  laboured  under  palpitation  of 
her  heart,  and  difficult  breathing  on  the  leaft  exercife,  with  oc- 
eafional  violent  dry  cough,  for  a  year  or  more,  with  dry  lips, 
little  appetite  either  for  food  or  drink,  and  dry  fkin,  with  cold 
extremities.  She  has  at  times  been  occafionaliy  worfe,  and  been 
relieved  in  fome  degree  by  the  bark.  She  began  to  bend  for- 
wards, and  to  lift  up  her  ftioulders.  The  former  feemed  owing 
to  a  beginning  curvature  of  the  fpine,  the  latter  was  probably 
caufed  to  facilitate  her  difficult  refpiration. 

M.  M.  She  ufed  the  warm  bath,  as  above  related  ;  which  by 
its  warmth  might  increafe  the  irritability  of  the  {mailed  feries 
of  veflels,  and  by  fupplying  more  moifture  to  the  blood  might 
probably  tend  to  carry  further  the  materials,  which  form  calca- 
reous or  bony  particles,  or  to  convey  them  in  more  dilute  folu- 
tion.  She  took  twice  a  day  twenty  grains  of  extract  of  bark, 
twenty  grains  of  foda  phofphorata,  and  ten  grains  of  chalk,  and 
ten  of  calcined  hartmorn  mixed  into  a  powder  with  ten  drops 
of  laudanum;  with  flefti  food  both  to  dinner  and  fupper  •,  and 
port  wine  and  water  inftead  of  the  fmall  beer  me  had  been  ac- 
cuftomed  to ;  (lie  lay  on  a  fofa  frequently  in  a  day,  and  occafion- 
aliy ufed  a  neck-fwing. 

There  is  no  fituation,  where  the  foftnefs  of  the  bones  and 
consequent  deformity  of  them  is  fo  frequently  attended  with 
calamitous  confequences,  as  when  it  affects  the  bones  of  the 
pelvis,  fo  as  to  contract  the  form  of  it;  whence  many  unfortu- 
nate women  have  loft  their  infants,  or  perifhed  themfelves.  In 
this  miferable  fituation  of  the  pregnant  uterus,  fome  have  deftroy- 
ed  the  child,  others  have  undergone  the  Cefarean  operation, 

and 


GLASS  I.  2.  2.  i£.     OF  IRRITATION.  73 

and  have  thence  generally  periihed  themfelves.  But  Dr.  Den- 
man  has  ingenioufly  introduced  a  new  practice,  which  has  faved , 
in  fuch  cafes,  both  the  mother  and  child  ;  which  is  by  promo- 
ting a  premature  delivery  between  the  feventh  and  eighth  months, 
before  the  child  has  acquired  its  full  growth,  which  has  been  at- 
tended with  fuccefs.  See  Denman's  Midwifery,  and  Medical 
journal,  Vol.  III.  No.  1 1. 

In  one  inftance,  nature  feems  to  have  had  a  fimilar  expedient, 
md  perhaps  to  overcome  a  fimilar  difficulty,  in  the  premature 
>irth  of  the  progeny  of  the  kanguroo  ;  whofe  young  are  exclu- 
led  from  the  uterus  in  a  very  early  ftate  of  their  growth,  and  re- 
ceived into  an  exterior  bag  ;  which  is  furnimed  with  teats,  to 
which  they  long  adhere  by  their  mouths,  till  they  are  ready  for 
a  fecond  birth. 

15.  Rachitis.  Rickets.     The  head  is  large,  protuberant  chief-? 
ly  on  the  forepart.     The  fmaller  joints  are  fwelled  ;  the  ribs  de- 
preffed  ;  the  belly  tumid,  with  other  parts  emaciated.     This  dif- 
cafe  from  the  innutrition  or  foftnefs  of  the  bones  arofe  about  two 
centuries  ago  •,  feems  to  have  been  half  a  century  in  an  increaf. 
ing  or  fpreading  itate  ;  continued  about  half  a  century  at  its 
height,  or  greateit  diffufion  ;  and  is  now  nearly  vanifhed  :  which 
gives  reafon  to  hope,  that  the  fmall-pox,  meafles,  and  venereal 
difeafe,  which  are  all  of  modern  production,  and  have  already- 
become  milder,  may  in  procefs  of  time  vanifh  from  the  earth, 
and  perhaps  be  fucceeded  by  new  ones !     See  the  preceding 
Species. 

1 6.  Spina  dijlortio.     Diftortion  of  the  fpirfe  is  another  difeafe 
originating  from  the  innutrition  or  foftnefs  of  the  bones.     I  once 
faw  a  child  about  fix   years  old  with  palpitation  of  heart,  and 
quicknefs  of  refpiration,  which  began  to  have  a  curvature  of  the 
fpine  •,  I  then  doubted,  whether  the  palpitation  and  quick  refpi- 
ration were  the  caufe  or  confequence  of  the  curvature  of  the 
fpine  j  fufpe&ing  either  that  nature  had  bent  the  fpine  outwards 
to  give  room  to  the  enlarged  heart ;  or  that  the  malformation  of 
the  cheft  had  compreiled  and  impeded    the  movements  of  the 
heart.     But  a  few  weeks  ago  on  attending  a  young  lady  about 
ten  years  old,  whofe  fpine  had  lately  begun  to  be  distorted,  with 
very  great  difficulty  and  quicknefs  of  refpiration,  and  alarming 
palpitation  of  the  heart,  I  convinced  myfelf,  that  the  palpitation 
and  difficult  refpiration  were  the  effect  of  the  change  of  the  cav- 
ity of  the  cheft  from  the  diftortion  of  the  fpine  ;  and  that  th<- 
whole  was  therefore  a  difeafe  of  the  innutrition  or  foftnefs  of  the 
bones. 

For  on  directing  her   to  lie  down  much  in  the  day,  and  to 

take  the  bark,  the  diftortion  became  lefs,  and  the  palpitation  and 

VOL.  II.  L  quick 


74  DISEASES  CLASS  I.  2.  2.  16. 

quick  refpiration  became  lefs  at  the  fame  time.  After  this  ob- 
fervation  a  neck-fwing  was  directed,  and  fhe  took  the  bark, 
madder,  and  bone-afhes  ;  and  (he  continues  to  amend  both  in 
her  Ihape  and  health. 

Delicate  young  ladies  are  very  liable  to  become  awry  at  many 
boarding-fchools.  This  is  occafioned  principally  by  their  being 
obliged  too  long  to  preferve  an  erect  attitude,  by  fitting  on  forms 
many  hours  together.  To  prevent  this,  the  fchool-feats  mould 
have  either  backs,  on  which  they  may  occafionally  reft  them- 
felves  ;  or  delks  before  them,  on  which  they  may  occafionally  lean. 
This  is  a  thing  of  greater  confequence  than  may  appear  to  thofe, 
who  have  not  attended  to  it. 

When  the leaft  tendency  to  become  awry  is  obferved,they  fhoulcf 
be  advifed  to  lie  down  on  a  bed  or  fofa  for  an  hour  in  the  middle  of 
the  day  for  many  months  ;  which  generally  prevents  the  increafc 
of  this  deformity  by  taking  off  for  a  time  the  preflure  on  the  fpine 
of  the  back,  and  it  at  the  fame  time  tends  to  make  them  grow 
taller.  Young  perfons,  when  nicely  meafured,  are  found  to  be 
half  an  inch  higher  in  a  morning  than  at  night ;  as  is  well 
known  to  thofe  who  inlift  very  young  men  for  foldiers.  This 
is  owing  to  the  cartilages  between  the  bones  of  the  back  becom- 
ing comprerTed  by  the  weight  of  the  head  and  moulders  on  them 
during  the  day.  It  is  the  fame  preflure  which  produces  curva- 
tures and  diftortions  of  the  fpine  in  growing  children,  where 
the  bones  are  fofter  than  ufual ;  and  which  may  thus  be  relieved 
by  an  horizontal  pofture  for  an  hour  in  the  middle  of  the  day, 
or  by  ."being  frequently  allowed  to  lean  on  a  chair,  or  to  play  on, 
the  ground  on  a  carpet. 

Young  ladies  {hould  alfo  be  directed,  where  two  deep  in  a 
bed,  to  change  every  night,  or  every  week,  their  fides  of  the  bed  ; 
•which  will  prevent  their  tendency  to  fleep  always  on  the  fame 
fide  •,  which  is  not  only  liable  to  produce  crookednefs,  but  alfo 
to  occafion  diieafes  by  the  internal  parts  bein-g  fo  long  kept  in 
uniform  contact  as  to  grow  together.  For  the  fame  reafon  they 
{hould  not  be  allowed  to  fit  always  on  the  fame  fide  of  the  fire 
or  window,  becaufe  they  will  then  be  inclined  too  frequently  to 
bend  themfelves  to  one  fide. 

Another  great  caufe  of  injury  to  the  fhape  of  young  ladies  is 
from  the  prefTure  of  ftays,  or  other  tight  bandages,  which  at  the 
fame  time  caufe  other  difeafea  by  changing  the  form  or  fituation 
of  the  internal  parts.  If  a  hard  part  of  the  flays,  even  a  knot 
of  the  thread,  with  which  they  are  fewed  together,  is  prefTed 
hard  upon  one  fide  more  than  the  other,  the  child  bends  from 
the  fide  moft  painful,  and  thus  occafions  a  curvature  of  the  fpine. 
To  counteract  this  effect,  fuch  itays  as  have  feweft  hard  p 

and 


CLASS  I.  2.  2.  1 6.       OF  IRRITATION.  7* 

and  efpecially  fuch  as  can  be  daily  or  weekly  turned,  are  pref- 
erable to  others. 

Where  frequent  lying  down  on  a  fofa  in  the  day-time,  and 
Twinging  frequently  for  a  fhort  time  by  the  hands  or  head,  with 
loofe  drefs,  do  not  relieve  a  beginning  diftortion  of  the  back  ;  re- 
courfe  maybe  had  to  a  chair  with  fluffed  moveable  arms  for  the 
purpofe  of  fufpending  the  weight  of  the  body  by  cufhions  under 
the  arm-pits,  like  reiting  on  crutches,  or  like  the  leading-fl; 
of  infants.  From  the  top  of  the  back  of  the  lame  chair  a  curv- 
ed fteel  bar  may  alfo  project  to  fufpend  the  body  occafion ally, 
or  in  part  by  the  head,  like  the  fwing  above  mentioned.  The 
ufe  of  this  chair  is  more  efficacious  in  ft raightening  the  fpine, 
than  fimply  lying  down  horizontally  ;  as  it  not  only  takes  off  the 
preffure  of  the  head  and  (boulders  from  the  fpine,  but  at  the 
fame  time  the  inferior  p?.vts  of  the  body  contribute  to  draw  the 
fpiae  (Iraight  by  their  weight  ;  or  laftly,  recourfe  may  be  had 
to  a  fpinal  machine  firil  defcribed  in  the  Me  moires  of  the  acad- 
emy of  furgery  in  Paris,  Vol.  I'll.  p.  600,  by  M.  Le  Vacher,  and 
iince  made  by  Mr.  Jones,  at  No.  6,  Nortk-ftreet,  Tottenham 
court-road,  London,  which  fufpeuds  the  head,  and  places  the 
weight  of  it  on  the  hips.  This  machine  is  capable  of  improve- 
ment by  joints  in  the  bar  at  the  back  of  it,  to  permit  the  body  to 
bend  forwards  without  diminishing  the  extenfion  of  the  fpine. 

The  objections  of  this  machine  of  M.  Vacher,  which  is  made 
by  Mr.  Jones,  are  firil,  that  it  is  worn  in  the  day-time,  and  has 
a  very  unfightly  appearance.  Mr.  Jones  has  endeavoured  to 
remedy  this,  by  taking  away  the  curved  bar  over  the  head,  and 
fubftituting  in  its  place  a  forked  bar,  rifmg  up  behind  each  ear, 
\vith  webs  fattened  to  it,  which  pafs  under  the  chin  and  occiput. 
But  this  is  not  an  imprdvement,but  a  deterioration  of  M.  Vacher' s 
2nachine,as  it  prevents  the  head  from  turning  with  facility  to  either 
fide.  Another  objection  is,  that  its  being  worn,  when  the  muf- 
cles  of  the  back  are  in  action,  it  is  rather  calculated  to  prevent 
the  curvature  of  the  fpine  from  becoming  greater,  tha,nto  extend 
the  fpine,  and  diminifh  itj  curvature. 

For  this  latter  purpofe  I  have  made  a  fteel  bow,  which  re- 
ceives the  head  longitudinally  from  the  forehead  to  the  occiput ;, 
having  a  fork  furniftied  with  a  web  to  fuitain  the  chin,  and  an- 
other to  futtain  the  occiput.  The  fummit  of  the  bow  is  fixed 
by  a  fwivel  to  the  board  going  behind  the  head  of  the  bed  above 
the  pillow.  The  bed  is  to  be  inclined  from  the  head  to  the  feet 
•about  twelve  or  fixteen  inches.  Hence  the  patient  would  be 
conflantly  Hiding  down  during  ileep,  unlefs  fupported  by  this 
bow,  with  webbed  forks,  covered  alfo  with  fur,  placed  beneath 
the  chin,  and  beneath  the  occiput.  There  are  alfo  proper  webs 


7  6  DISEASES  CLASS  1.2.2.16. 

lined  with  fur  for  the  hands  to  take  hold  of  occafionally,  and  aL 
fo  to  go  under  the  arms.  By  thefe  means  I  mould  hope  great 
advantage  from  gradually  extending  the  fpine  during  the  inac- 
tivity of  the  mufcles  of  the  back  ;  and  that  it  may  be  done  with- 
out difturbing  the  fleep'of  the  patient,  and  if  this  fhouid  hap- 
pen, the  bow  is  made  to  open  by  a  joint  at  the  fummit  of  it,  fo  as 
to  be  inftantly  difengaged  from  the  neck  by  the  hand  of  the 
•wearer.  This  bow  I  have  now  ufed  with  advantage  on  one  pa- 
tient, and  it  may  be  had  from  Mr,  Harrifon,  whitefrnith,  Bridge- 
gate,  Derby. 

It  is  alfo  poflible  that  a  flight  comprefs  on  the  prominent  part 
of  a  curved  fpine  might  be  applied  with  advantage  both  in  fleep 
and  in  waging  hours,  if  it  could  be  nicely  held  on  the  part  by  a 
weak  and  very  flexible  fpring,  with  a  proper  counter-prefiure  on 
fome  diftant  part ,  but  this  would  require  more  art  than  could 
be  managed,  except  by  thofe  who  have  very  accurate  mechanical 
ideas,  and  mull  differ  with  every  kind-  of  curvature.  Thus  if 
the  prominent  part  of  the  curve  of  the  fpine  be  on  one  fide,  a, 
fluffed  cufhiqn  fixed  to  the  centre  of  a  long  thin  fleel  fpring 
fhould  be  applied  on  the  prominence  5  one  end  of  this  long 
fpring  fhould  be  bent  by  a  flrap  joined  to  a  waiftcoat  on  the  op- 
pofite  fhpulder,  and  the  other  end  of  it  by  a  ftrap  joined  to  draw- 
ers on  the  oppofite  hip  ;  the  degree  of  preffure  to  be  adjufled 
by  the  tightnefs  of  thefe  {traps.  If  the  prominent  part  of  a 
curved  fpine  be  exaclly  behind,  the  ends  of  the  long  fpring 
ihould  extend  from  the  loweft  bone  of  the  neck  to  the  os  cocci- 
gis3  and  fhould  have  its  two  ends  attached  to  the  jtop  of  a  waift- 
coat, and  to  the  waiftband  of  a  pair  of  drawers. 

It  will  be  from  hence  eafily  perceived,  that  all  other  methods 
of  confining  or  directing  the  growth  of  young  people  fhould  be 
ufed  with  great  Hull ;  fuch  as  back-  boards,  or  bandages,  or  flocks 
for  the  feet ;  and  that  their  application  fhould  not  be  continued 
too  long  at  a  time,  left  worfe  confequences  ihould  enfue,  than 
tjie  deformity  they  were  defigned  to  remove.  To  this  maybe 
added,  that  the  fliff  erecl:  attitude  taught  by  fome  modern  danc- 
ing mafters  does  not  contribute  to  the  grace  of  perfon,  but  rather 
militates  again  ft  it  ;  as  is  well  feen  in  one  of  the  prints  in  Ho- 
garth's Analyfis  of  Beauty  ;  and  is  exemplified  by  the  eafy  grace 
of  fome  of  the  ancient  ftatues,  as  of  the  Venus  de  Medicis,  and 
the  Antinous,  and  in  the  works  of  fcrne  modern  artifls,  as  in  a 
beautiful  print  of  Hebe  feeding  an  Eagle,  painted  by  Hamilton, 
and  engraved  by  Egintop,  and  many  of  the  figures  of  Angelica 
J.vauffman. 

Where  the  bone  of  one  of  the  vertebrae  of  the  back  has  been 
Dwelled  on  both  fides  of  it,  fo  as  to  become  protuberant,  iffue& 

near 


CLASS  I.  2.  2.  17.        OF  IRRITATION.  77 

near  the  fwelled  part  have  been  found  of  great  fervice,  as  men- 
tioned in  Species  1 8  of  this  Genus.  This  has  induced  me  to 
propofe  in  curvatures  of  the  fpine,  to  put  an  iflue  on  the  outfide 
of  the  curve,  where  it  could  be  certainly  afcertained,  as  the  bones 
on  the  convex  fide  of  the  curve  muft  be  enlarged  •,  in  one  cafe  I 
thought  this  of  fervice,  and  recommend  the  further  trial  of  it. 

In  the  tendency  to  curvature  of  the  fpine,  whatever  ftrength- 
ens  the  general  conftitution  is  of  fervice  ;  as  the  ufe  of  the  cold 
bath  in  the  fummer  months.  This  however  requires  fome  re- 
ftri&ion  both  in  refpeft  to  the  degree  of  coldnefs  of  the  bath, 
the  time  of  continuing  in  it,  and  the  feafon  of  the  year.  Com- 
mon fprings,  which  are  of  forty-eight  degrees  of  heat,  are  too 
cold  for  tender  conductions,  whether  of  children  or  adults,  and 
frequently  do  them  great  and  irreparable  injury.  The  coldnefs 
of  river- water  in  the  fummer  months,  which  is  about  (ixty-eight 
degrees,  or  that  of  Matlock,  which  is  about  fixty-eight,  or  of 
Buxton,  which  is  eighty-two,  are  much  to  be  preferred.  The 
time  of  continuing  in  the  bath  mould  be  but  a  minute  or  two, 
or  not  fo  long  as  to  occafion  a  trembling  of  the  limbs  from  cold. 
In  refpeft  to  the  feafon  of  the  year,  delicate  children  mould 
certainly  only  bathe  in  the  fummer  months  ;  as  the  going  fre- 
quently into  the  cold  air  in  winter  will  anfwer  all  the  purpofes 
of  the  cold  bath. 

17.  Claudicat'io  coxaria.  Lamenefs  of  the  hip.  A  nodding 
of  the  thigh-bone  is  faid  to  be  produced  in  feeble  children  by  the 
foftnefs  of  the  neck  or  upper  part  of  that  bone  beneath  the  car- 
tilage ;  which  is  naturally  bent,  and  in  this  difeafe  bends  more 
downwards,  or  nods,  by  the  preflure  of  the  body  ;  and  thus 
renders  one  leg  apparently  fhorter  than  the  other.  In  other 
cafes  the  end  of  the  bone  is  protruded  out  of  its  focket,  by  in- 
flammation or  enlargement  of  the  cartilages  or  ligaments  of  the 
joint,  fo  thai  it  reits  on  fome  part  of  the  edge  of  the  acetabu- 
lum,  which  in  time  becomes  filled  up.  When  the  legs  are 
ftraight,  as  in  (landing  erect,  there  is  no  verticillary  motion  in 
the  knee-joint  ;  all  the  motion  then  in  turning  out  the  toes  fur- 
ther than  nature  defigned,  muft  be  obtained  by  draining  in  fome 
degree  this  head  of  the  thigh-bone,  or  the  acetabulum,  or  cavi- 
ty, in  which  it  moves.  This  has  induced  me  to  believe,  that  this 
misfortune  of  the  nodding  of  the  head  of  the  bone,  or  partial 
•diflocation  of  it,  by  which  one  leg  becomes  fhorter  than  the  other, 
i;i  fometimes  occafioned  by  making  very  young  children  (land  in 
what  are  called  {locks  ;  that  is  with  their  heels  together,  and 
their  toes  quite  out.  Whence  the  focket  of  the  thigh-bone  be- 
comes inflamed  and  painful,  or  the  neck  of  the  bone  is  bent 
downward  and  outwards. 

In 


?S  DISEASES  CLASS!.  2. 2.  iS. 

'  In  this  cafe  there  is  no  expectation  of  recovering  the  ftraight- 
nefs  of  the  end  of  the  bone ;  but  thefe  patients  are  liable  to 
another  misfortune,  that  is,  to  acquire  afterwards  a  diftor^ 
tion  of  the  fpine  ;  for  as  one  leg  is  fhorter  than  the  other,  they 
fmk  on  that  fide,  and  in  confequence  bend  the  upper  part  of 
their  bodies,  as  their  moulders,  the  contrary  way,  to  balance 
themfelves;  and  then  again  the  neck  is  bent  back  again  towards 
the  lame  fide,  to  preferve  the  head  perpendicular ;  and  thus  the 
figure  becomes  quite  diftorted  like  the  letter  S,  owing  original- 
ly to  the  deficiency  of  the  length  of  one  limb.  The  only  way 
to  prevent  this  curvature  of  the  fpine  is  for  the  child  to  wear  a 
high-healed  (hoe  or  patten  on  the  lame  foot,  fo  as  to  fupport  that 
fide  on  the  fame  level  with  the  other,  and  thus  to  prevent  a 
greater  deformity. 

I  have  this  day  feen  a  young  lady  about  twelve,  who  does  not 
limp  or  waddle  in  walking ;  but  rteverthelefs,  when  me  ftands 
or  fits,  me  finks  down  towards  her  right  fide,  and  turns  out  that 
toe  more  than  the  other.  Hence,  both  as  me  'fits  and  ftands, 
{he  bends  her  body  to  the  right ;  whence  her  head  would  hang 
a  little  over  her  right  fhoulder  •,  but  to  replace  this  perpendicu- 
larly, me  lifts  up  her  left  fhouider  and  contracts  the  mufcles  on 
that  fide  of  the  neck  ;  which  are  therefore  become  thicker  and 
ilronger  by  their  continued  aftion  5  but  there  is  not  yet  any  very 
perceptible  diftortion  of  the  fpine. 

As  her  right  toe  is  turned  outward  rather  more  than  natural, 
this  mews  the  difeafe  to  be  in  the  hip-joint ;  becaufe,  when  the 
limb  is  ftretched  out,  the  toe  cannot  turn  horizontally  in  the 
leaft  without  moving  the  end  of  the  thigh-bone  ;  although  when 
the  knee  is  bent,  the  toe  can  be  turned  through  one  third  or  half 
of  a  circle  by  the  rotation  of  the  tibia  and  fibula  of  the  leg  round 
each  other.  Hence  if  children  are  fet  in  flocks  with  their  heels 
touching  each  other  as  they  fit,  and  are  then  made  to  rife  up, 
till  they  ftand  erect,  the  focket  or  head  of  the  thigh-bone  becomes 
injured,  efpecially  in  thofe  children,  whofe  bones  are  foft  ;  and 
a  fhortnefs  of  that  limb  fucceeds  either  by  the  bending  of  the 
neck  of  the  thigh-bone,  or  by  its  getting  out  of  the  acetabulum  ; 
and  a  confequcnt  rifing  of  one  moulder,  and  a  curvature  of  the 
fpine  are  produced  from  fo  diflant  a  caufe. 

M.  M.  An  el  a  Hi  c  cufhion  made  of  curled  hair  mould  be  pla- 
ced under  the  affected  hip,  whenever  (he  fits  ;  or  mould  be  fit- 
ted to  the  part  by  means  of  drawers,  fo  that  fhe  cannot  avoid 
fitting  on  it.  A  neck-fwing,  and  lying  down  in  the  day,  mould 
be  occafionally  ufed  to  prevent  or  remove  any  curvature  of  the 
fpine.  The  reft  as  in  Species  1 3  and  1 5  of  this  genus. 

1 8.  S  uberam*  Protuberant  ijpine.  One  of  the  bones 

of 


CLASS  I.  2.  2.  19-     OF  IRRITATION.  79 

of  the  fpine  fwells,  and  rifes  above  the  reft.  This  is  not  an  un- 
common difeafe,  and  belongs  to  the  innutriton  of  the  bones,  as 
the  bone  muft  become  foft  before  it  fvvells  •,  which  foftnels  is 
owing  to  defect  of  the  fecretion  of  phoiphorated  calcareous  earth. 
The  f welling  of  the  bone  compreifes  a  part  of  the  brain,  called 
the  fpinal  marrow,  within  the  cavity  of  the  back-bones ;  and  in 
confequence  the  lower  limbs  become  paralytic,  attended  fome- 
times  with  difficulty  of  emptying  the  bladder  and  rectum. 

M,  M.  IfTues  put  on  each  fide  of  the  prominent  bone  are  of 
•eat  effect,  I  fuppofe,  by  their  ftimulus  ;  which  excites  into 
ction  more  of  the'  fenibrral  powers  of  irritation  and  fenfation, 
nd  thus  gives  greater  activity  to  the  vafcular  fyftem  in  their 
icinity.  The  methods  recommended  in  diftortion  of  the  fpine 
re  alfo  to  be  attended  to. 

19.  Spina  bifida.     Divided  fpine,  called  alfo  Hydrorachitis,  as 
well  as  the  Hydrocephalus  e,xternus,   is  probably  owing  in  pare 
to  a  defect  of  offification  of  the  fpine  and  cranium  ;  and  the  col- 
lection of  fluid  beneath  them  may  originate  from  the  general  de- 
bility of  the  fyftem  j  which  affects  both  the  fecerning,  and  ab- 
forbent  veflfels. 

A  curious  circumftance,  which  is  affirmed  to  attend  the  fpina 
bifida,  is,  that  on  compreffing  the  tumor  with  the  hand  gently, 
the  whole  brain  becomes  affected,  and  the  patient  falls  afleep.  I 
fuppofe  the  feme  muft  happen  on  compreffing  the  hydrocephalus 
externus  ?  See  Sett.  XVIII.  20. 

20.  Offis  palati  defeftus.     A  defect  of  the  bone  of  the  palate, 
which   frequently  accompanies  a  divifion  of  the  upper  lip,  oc- 
curs before  nativity  •,  and  is  owing  to  the  deficient  action  of  the 
fecerning  fyftem,  from  whence  the  extremities  are  not  comple- 
ted.    From  a  fimilar  caufe  I  have  feen  the  point  of  the  tongue 
deficient,  and  one  joint  of  the  two  leaft  fingers,'  and  of  the  two 
lead  toes,  in  the  fame  infant ;  who  was  otherwife  a  fine  girL 
See  Sect.     XXXIX.  4.  4. 

The  operation  for  the  hare-lip  is  r.efcribed  by  many  furgical 
writers ;  but  there  is  a  perfon  in  London,  who  makes  very  ingeni- 
ous artificial  palates  ;  which  prevent  that  defect  of  fpeech,  which 
attends  this  malformation.  This  factitious  palate  confifts  of  a 
thin  plate  of  filver  of  the  ihape  and  form  of  the  roof  of  the  mouth ; 
from  the  front  edge  to  the  back  edge  cf  this  filver  plate  four 
or  five  holes  are  made  in  a  ftraigrft  line  large  enough  for  a  needle 
to  pafs  through  them  -,  on  the  back  of  it  is  then  fewed  a  piece  of 
fponge ;  which  when  expanded  with  moifture  is  nearly  as  large 
as  the  filver  plate.  This  fponge  is  flipped  through  the  divifiou 
ef  the  bone  of  the  palate,  fo  as  to  lie  above  it,  while  the  filver 

plate- 


DISEASES 


CLASS  I.  2.  2. 


plate  covers  the  aperture  beneath,  and  is  fufpended  by  the  ex- 
panding fponge.  This  is  removed  every  night  and  wafhed,  and 
returned  into  its  place  in  the  morning  j  on  this  account  it  is  con- 
venient to  have  five  or  fix  of  them,  for  the  fake  of  cleanlinefs.  I 
have  been  more  particular  in  defcribing  this  invention,  as  I  do 
not  know  the  name,  or  place  of  refidence,  of  the  maker. 


ORDG 


:LASS  I.  a.  3.  i.  OF  IRRITATION,  *i 

ORDO  II. 

Decreafed  Irritation. 

GENUS  III. 
With  decreafed  Aclion  of  the  Abforbent  Syjlem. 

SOME  decreafe  of  heat  attends  thefe  difeafes,  though  in  a  lets 
;gree  than  thofe  of  the  laft  genus,  becaufe  the  abforbent  fyftem 
"  glands  do  not  generate  fo  much  heat  in  their  healthy  ftate  of 

tion  as  the  fecerning  fyftem  of  glands,  as  explained  in  Clafs 

i-  3- 

SPECIES. 

1.  Mucus  faucium  frigidus.     Cold  mucus  from   the  throat* 
Jvluch  mucus,  of  rarher  a   faline  tafte,  and  lefs  mfpifiated  than 
ulual,  is  evacuated  from  the  fauces  by   hawking,   owing  to  the 
deficient  abibrption  of  the  thinner  parts  of  it.     This  becomes  a 
habit  in  feme  elderly  people,  who  are  continually  fpitting  it  out 
of  their  mouths ;  and  has  probably  been  brought  on  by  taking 
ihuff,  or  fmoking  tobacco ;  which  by  frequently  ftimulating  the 
fauces  have  at  length  'rendered  the  abforbent  veiTels  lefs  excita- 
ble by  the  natural  ftimulus  of  the  faline  part  of  the  fecretion, 
•which  ought  to  be  reabforbed,  as  ibon  as  fecreted. 

M.  M.  A  few  grains  of  powder  of  bark  frequently  put  into 
the  mouth,  and  gradually  diffufed  over  the  fauces.  A  gargle  of 
barley  water. 

2.  Sudor frigidus.     The  cold  dampnefs  of  the  hands  of  fome 
people  is  caufed  by  the  deficient  abforption  of  perfpirable  matter  ; 
the  clammy  or  vifcid  feel  of  it  is  owing  to  the  mucous  part  being 
left  upon  the  (kin.     The  coldnefs  is  produced  both  by  the  de- 
creafed action  of  the  abforbent  fyftem,  and  by  the  evaporation  of 
a  greater  quantity  of  the  perfpirable  matter  into  the  air,  which 
ought  to  have  been  abforbed. 

M.  M.  Warn  the  hands  in  lime  water,  or  with  a  fmall  quan- 
tity of  volatile  alkali  in  water. 

3.  Catarrhus  frigidus.  The  thin  difcharge  from  the  noftrils 
in  cold  weather.  The  abforbent  veflels  become  torpid  by  the 
diminution  of  external  heat,  fooner  than  the  fecerning  ones, 
which  are  longer  kept  warm  by  the  circulating  blood,  from 
which  they  felecl:  the  fluid  they  fecrete  j  whereas  the  abiorb^nt 

VOL.  II.  M  veiieis 


DISEASES  CLASS  I.  2. 


vefTels  of  the  noftrils  drink  up  their  fluids,  namely  the  thin  and 
faline  part  of  the  mucus,  after  it  has  been  cooled  by  the  atmof- 
phere.  Hence  the  abforbents  ceafing  to  act,  and  the  fecerning 
yeiTeJs  continuing  fome  time  longer  to  pour  out  the  mucus,  a 
•copious  thin  discharge  is  produced,  which  trickles  down  the 
noitrils  in  cold  weather.  This  difcharge  is  fo  acrid  as  to  inflame 
the  upper  lip ;  which  is  owing  to  the  neutral  felts,  with  which 
it  abounds,  not  being  reabforbed  ;  fo  the  tears  in  the  fiftula  lach- 
rymalis  inflame  the  cheek.  See  Clafs  I.  i.  2.  7. 

4.  ExpeEloratio  frigida.  Cold  expectoration.  Where  the 
pulmonary  abforption  is  deficient,  an  habitual  cough  is  produced, 
and  a  frequent  expectoration  of  thin  faline  mucus ;  as  is  often 
feen  in  old  enfeebled  people.  Though  the  ftimulus  of  the  faline 
fluid,  which 'attends  all  fecretions,  is  not  fufficient  to  excite  the 
languid  abforbent  veflels  to  imbibe  it ;  yet  this  faline  part,  to- 
gether with  the  increafed  quantity  of  the  whole  of  the  fetreted 
mucus,  flimulates  the  branches  of  the  bronchia,  fo  as  to  induce 
an  almoft  inceflant  cough  to  difcharge  it  from  the  lungs.  A 
lingle  grain  of  opium,  or  any  other  ilimulant  drug,  as  a  wine 
poffet  with  fpirit  of  hartftiorn,  will  cure  this  cold  cough,  and  the 
cold  catarrh  of  the  preceding  article,  like  a  charm,  by  ftimula- 
ting  the  torpid  mouths  of  the  abforbents  into  action.  Which 
has  given  rife  to  an  indifcriminate  and  frequently  pernicious  ufe 
of  the  warm  regimen  in  coughs  and  catarrhs  of  the  warm  or 
inflammatory  kind,  to  the  great  injury  of  many. 

M.  M.  Half  a  grain  of  opium  night  and  morning  promotes 
the  abforption  of  the  more  fluid  and  faline  parts,  and  in  confe-* 
quence  thickens  the  mucus,  and  abates  its  acrimony.  Warm 
diluent  drink,  wine- whey,  with  volatile  alkali. 

5.  Unnanberior  pallida.  On  being  expofed  naked  to  cold 
air,  or  fprinkled  with  cold  water,  a  quantity  of  pale  urine  is  foon 
diicharged  ;  for  the  abforbents  of  the  bladder  become  torpid  by 
their  fympathy  with  thofe  of  the  {kin  *,  which  are  rendered  qui- 
cfcent  by  the  diminution  of  external  heat ;  but  the  kidneys  con- 
tinue to  fecrete  the  urine,  and  as  no  part  of  it  is  abforbed,  it  be- 
comes copious  and  pale.  This  happens  from  a  finiilar  caufe  in 
.cold  fits  of  agues  ;  and  in  lefs  degree  to  many  debilitated  confti- 
tutions,  whole  extremities  are  generally  cold  and  pale.  The 
great  quantity  of  limpid  water  in  hyfleric  cafes,  and  in  diabetes, 
belongs  to  Clafs  I.  3.  i.  10.  I.  3.  2.  6. 

M.  M.  Tincture  of  cantharides,  opium,  alum,  forbentia. 
Tlatmel  (hirt  in  cold  weather.  Animal  food.  Beer.  Wine. 
Friction.  Exercife.  Fire. 

6.  Diarrhoea  frigida.    Liquid  {tools  are  produced  by  expofing 

the 


,ss  I.  2.  3-  7-          OF  IRRITATION. 

the  body  naked  to  cold  air,  or  fprinkling  it  with  cold  water,  for 
the  fame  reafon  as  the  laft  article. 

But  this  diie^-e  is  fometimes  of  a  dangerous  nature ;  the  in- 
-teftinal  abforption  being  fo  impaired,  that  the  aliment  is  faid  to 
come  away  unJiminifhed  in  quantity,  and  almoft  unchanged  by 
the  powers  of  digeflion,  and  is  then  called  lientery. 

The  mucus  of  the  rectum  fometimes  cemes  away  like  pellu- 
.cid  hart  (hoi  n  jelly,  .and  liquefies  by  heat  like  that,  towards  the 
end  of  inirritative  fevers,  which  is  owing  to  the  thinner  part  of 
;the  mucus  not  bting  abforbed,  and  thus  refenables  the  catarrh  of 
feme  old  people. 

M.  M.  Opium,  campechy  wood,  armenian  bole.  Blifler. 
-Flannel  iliirt  in  cold  weather.  Clyfters  with  opium.  Friction. 
on  the  bowels  morning  and  night.  Equitation  twice  a  day. 

7.  Fluor  albus  frigidus.     Cold  fluor  albus.     In  weak  conftitu- 
tions,  where  this  discharge  is  pellucid  and  thin,  it  muft  proceed 
from  want  of  abforption  of  the  mucous  membrane  of  the  vagina, 
or  uterus,  and  not  from  an  increafed  fecretion.     This  I  fufpect 
to  be  the  moft  frequent  kind  of  fluor  albus  ;    the  former  one  de- 
icribed  at  Clafs  I.    I.   2.    n.  attends  menftruation,  or  is  a  dif- 
charge  inftead  of  it,  and  thus  refembles  the  venereal  orgafm  of 
female  quadrupeds.     The  difeharge  in  the  cold  kind  being  more 
faline,  is  liable  to  excoriate  the  part,  and  thus  produce  fmarting 
in  making  water  ;  in  its  great  degree  it  is  difficult  to  cure. 

M.  M.  Increafe  the  evacuation  by  ftool  and  by  perfpiration, 
by  taking  rhubarb  every  night,  about  fix  or  ten  grains  with  one'; 
grain  of  opium  forfome  months.  Flannel  fhirt  in  winter.  Balfarn 
copaiva.  Gum  kino,  bitters,  chalybeates,  friction  over  the  whole 
jkin  with  flannel  morning  and  night.  Partial  cold  bath,  by 
fprinkling  the  loins  and  thighs,  or  fponging  them  with  cold 
water.  Mucilage  as  ifinglafs  boiled  in  milk  ;  blanc  mange, 
hartfhorn  jelly,  are  recommended  by  fome.  Tincture  of  can- 
tharldes  fometimes  feems  of  fervice  given  from  ten  to  twenty 
drops  or  more,  three  or  four  times  a  day.  A  large  plafler  of 
burgundy  pitch  and  armenian  bole,  fo  as  to  cover  the  loins  and 
lower  part  of  the  belly,  is  faid  to  have  fometimes  fucceeded  by 
increasing  abforption  by  its  compreflion  in  the  manner  of  a  ban- 
dage. A  folution  of  metallic  falts,  as  white  vitriol,  fixty  grains 
to  a  pint ;  or  an  infufioa  of  oak-bark  may  be  injected  into  the 
vagina.  Cold  bath. 

8.  Gonorrkxa  frigida.     Cold  gleet.     Where  the  gleet  is  thin 
and  pellucid,  it  muft  arife  from  the  want  of  abforprioii  of  the 
membranes  of  the  urethra,  rather  than  from  an  increafed  fecre- 
tion from  them.     This  I  fuppofe  to  be  a  more  common  difeafe 

that  mentioned  at  Clafs  I.  i.  2.   10. 

M.  M.  Metallfc 


8~4  DISEASES  CLASS  I.  2.  3.  9^ 

M.  M.  Metallic  injections,  partial  cold  bath,  internal  method 
as  in  the  fluor  albus  above  defcribed.  Balfam  of  copaiva.  Tine-* 
ture  of  cantharides.  Introduce  a  few  inches  into  the  urethra  a 
bougie  fmeared  with  balfarn  of  copaiva.  See  Home  on  urethra, 
p.  105. 

9.  Hepatis  tumor.      The  liver  becomes  enlarged  from  defect 
of  the  abforption  of  mucus  from  its  cells,  as  in  anafarca,  efpeci- 
ally   in  feeble  children  ;  at   the  fame  time   lefs  bile  is  fecreted 
from  the  torpid  circulation  in  the  vena  portge.     And  as  the  ab- 
forbents,  which  refume  the  thinner  parts  of  the  bile  from  the 
gall-bladder  and  hepatic  ducts,  are  alfo  torpid  or  quiefcent,  the 
bile  is  more  dilute,  as  well  as   in   lefs  quantity.     From  the  ob- 
ftruclion  of  the  pafiage  of  the  blood  through  the  comprefled  ve- 
na porta  the fe  patients  have  tumid  bellies,  and  pale  bloated  coun- 
tenances ;  their  palenefs  is  probably  owing  to  the  deficiency  of 
the  quantity  of  red  globules  in  the  blood  in  conference   of  the 
inert  flate  of  the  bile. 

Thefe  fymptoms  in  children  are  generally  attended  with  worms, 
the  dilute  bile  and  the  weak  digeftion  not  deilroying  them.  In 
iheep  I  have  feen  fluke-worms  in  the  gall-duels  themfelves  among 
the  dilute  bile  5  which  gall-duels  they  eat  through,  and  then 
produce  ulcers,  and  the  hectic  fever,  called  the  rot.  See  Clafs 
L  1.4.  10.  and  Article  IV.  2.  6. 

M.  M.  After  a  calomel  purge,  crude  iron  filings  are  fpecific 
In  this  difeafe  in  children,  and  the  worms  are  deftroyed  by  the 
returning  acrimony  and  quantity  of  the  bile.  A  blifter  on  the 
Tegion  of  the  liver.  Sorbentia^  as  worm-feed,  fantonicum.  Co- 
lumbo.  Bark. 

The  nitrous  acid  has  been  ftrongly  recommended  by  Mr.  Scot 
5n  tumours  of  the  liver,  which  frequently  occur  in  the  eaft,  where 
this  gentleman  refides  ;  he  gives  two  drachms  of  ftrong  nitrous 
acid  mixed  with  two  pounds  of  water,  to  be  drunk  daily  at  in- 
tervals. See  Syphilis,  Clafs  II.  i.  5.  2. 

10.  Chlorofis.     When  the  defect  of  the  due  action  of  both  the 
abforbent  and  fecerning  veflels  of  the  liver  affects  women,  and  is 
attended  with  obftruclion  of  the  catamenia,  it  is  called  chlorofis ; 
and  is  cured  by  the  exhibition  of  fteel,  which  reftores  by  its  fpe- 
cific  ftimulus   the  abforbent  power  of  the  liver  ;  and  the  men- 
ftruation,  which   was  obftructed  in  confequence  of  debility, 
recurs. 

Indigeftion,  owing  to  torpor  of  the  ftomach,  and  a  confequent 
too  great  acidity  of  its  contents,  attend  this  difeafe  ;  whence  a 
defire  of  eating  chalk,  or  marl.  Sometimes  a  great  quantity  of 
pale  urine  is  difcharged  in  a  morning,  which  is  owing  to  the  in- 
jicticn  of  the  abforbents,  which  are  distributed  on  the  neck  of 

the 


CLASS  I.  2.  3.  ii.         OF  IRRITATION.  8^ 

the  bladder,  during  fieep.  The  fwelling  of  the  ankles,  which 
frequently  attends  chlorofis,  is  another  effect;  of  deficient  action, 
of  the  abforbent  fyitem  ;  and  the  pale  countenance  is  occafionecl 
by  the  deficient  quantity  of  red  globules  of  blood,  caufed  by  the 
deficient  quantity  or  acrimony  of  the  bile,  and  confequent  weak- 
I  nefs  of  the  circulation.  The  pulfe  is  fo  quick  in  fome  cafes  of 
chlorofis,  that,  when  attended  with  an  accidental  cough,  it  may 
be  miftaken  for  pulmonary  confumption.  This  quick  pulfe  is 
owing  to  the  debility  of  the  heart  from  the  want  of  ftimulus  oc- 
cafioned  by  the  deficiency  of  the  quantity,  and  acrimony  of  the 
blood. 

M.  M.  Steel.  Bitters.  Conftant  moderate  exercife.  Fric- 
tion with  flannel  all  over  the  body  and  limbs  night  and  morn- 
ing. Rhubarb  five  grains,  opium  half  a  grain,  every  night. 
Fle(h  diet,  with  fmall  beer,  or  wine  and  water.  The  difeafe 
continues  fome  months,  but  at  length  fubfides  by  the  treatment 
above  defcribed.  A  bath  of  about  eighty  degrees,  as  Buxton 
Bath,  is  of  fervice  ;  a  colder  bath  may  do  great  injury. 

ii.  Hydrocele.  Dropfy  of  the  vagina  teftis.  Dropfies  have 
been  divided  into  the  encyfted  and  the  diffufed,  meaning  thofe  of 
the  cellular  membrane,  the  cells  of  which  communicate  with  each 
other  like  a  fponge,  and  thofe  of  any  other  cavity  of  the  body. 
The  collections  of  mucous  fluids  in  rhe  various  cells  and  cavities 
of  the  body  arife  from  the  torpor  of  the  abforbent  veflels  of  thofe 
parts.  It  is  probable,  that  in  dropfies  attended  with  great  third 
the  cutaneous  abforbents  become  paralytic  firft  ;  and  then  from 
the  great  thirft,  which  is  thus  occafioned  by  the  want  of  atmof- 
pheric  moifture,  the  abforption  of  the  fat  enfues ;  as  in  fevers 
attended  with  great  thirft,  the  fat  is  quickly  taken  up.  See  Obe- 
fitas  I.  2.  3.  16.  Some  have  believed,  that  the  cellular  and  adi- 
pofe  membranes  are  different  ones  ;  as  no  fat  is  ever  depofited 
in  the  eyelids  or  fcrotum,  both  which  places  are  very  liable  to 
be  diftended  with  the  mucilaginous  fluid  of  the  anafarca,and  with 
air  in  Emphyfema.  Sometimes  a  gradual  abforption  of  the  ac- 
cumulated fluid  takes  place,  and  the  thinner  parts  being  taken 
up,  there  remains  a  more  vifcid  fluid,  or  alrnoft  a  folid  in  the 
pa'rt,  as  in  fome  fwelled  legs,  which  cannot  eailly  be  indented  by 
the  preflure  of  the  finger,  and  are  called  fcorbutic.  Sometimes 

»the   paralyfis  of  the  abforbents  is  completely  removed,   and  the 
whole  is  again  taken  up  into  the  circulation. 
The  Hydrocele  is  known  by  a  tumor   of  the  fcrotum,  whick 
is  without  pain,  gradually  produced,  with  fluctuation,  and  a  de- 
gree of  pellucidity,  when  a  candle  is  held  behind  it ;  it  is  the 
mod  fimple  incyfled  dropfy,  as  it  is  not  in  general  complicated 
other  difeafes,    as  afcites  with  fcirrhous  liver,  and  hydro- 

cephalui 


£<$  DISEASES  CLASS  I.  2. 3.  i*, 

cephalus  interims,  with  general  debility.  The  cure  of  this  dif- 
.cafe  is  effected  by  different  ways  ;  it  confifts  in  difcharging  the 
water  by  an  external  aperture  ;  and  by  fo  far  inflaming  the  cyft 
and  tefticle,  that  they  afterwards  grow  together,  and  thus  pre- 
vent in  future  any  fecretion  or  effufion  of  mucus  5  the  difeafe  is 
thus  cured,  not  by  the  revivefcence  of  the  abforbent  power  of  the 
lymphatics,  but  by  the  prevention  of  fecretion  by  the  adhefion  of 
the  vagina  to  the  teftis.  This  I  believe  is  performed  with  lefs 
pain,  and  is  more  certainly  manageable  by  tapping,  or  difcharg- 
ing the  fluid  by  means  of  a  trocar,  and  after  the  evacuation  of  it 
to  fill  the  cyft  with  a  mixture  of  wine  and  water  for  a  few  min- 
utes till  the  neceflary  degree  of  ftimulus  is  produced,  and  then  to 
withdraw  it ;  as  recommended  by  Mr.  Earle.  See  alfo  Medical 
Commentaries  by  Dr.  Duncan  for  1793. 

1 2.  Hydrocephalus  mternns^  or  dropfy  of  the  ventricles  of  the 
brain,  is  fatal  to  many  children,  and  fome  adults.  When  this 
difeafe  is  lefs  in  quantity,  it  probably  produces  a  fever,  termed  a 
nervous  fever,  and  which  is  fometimes  called  a  worm  fever,  ac- 
cording to  the  opinion  of  Dr.  Gilchrift,  in  the  Scots  Medical 
Eifays.  This  fever  is  attended  with  great  inirritability,  as  appears 
from  the  dilated  pupils  of  the  eyes,  in  which  it  correfponds  with 
the  dropfy  of  the  brain.  And  the  latter  difeafe  has  its  parox- 
yfms  of  quick  impulfe,  and  in  that  refpect  correfponds  with  oth- 
er fevers  with  inirritability. 

The  hydrpcephalus  internus  is  diftinguifhed  from  apoplexy  by 
Its  being  attended  with  fever,  and  from  nervous  fever  by  the 
paroxyfms  being  very  irregular,  with  perfect  intermiflions  many 
times  in  a  day.  In  nervous  fever  the  pain  of  the  head  generally 
affects  the  middle  of  the  forehead  ;  in  hydrocephalus  internus  it 
is  generally  on  one  fide  of  the  head.  One  of  the  earliefl  crite- 
rions  is  the  patient  being  uneafy  on  raifing  his  head  from  the  pil- 
low, and  wifhing  to  lie  down  again  immediately ;  which  I  fup- 
pofe  is  owing  to  the  preilure  of  the  water  on  the  larger  trunks 
of  the  blood-veffels  entering  the  cavity  being  more  intolerable 
than  on  the  fmaller  ones ;  for  if  the  larger  trunks  are  compreff- 
ed,  it  mufl  inconvenience  the  branches  alfo ;  but  if  fome  of  the 
fmall  branches  are  compreflbd  only,  the  trunks  are  not  fo  imme- 
diately incommoded. 

Blifters  on  the  head,  and  mercurial  ointment  externally,  with 
calomel  internally,  are  principally  recommended  in  this  fatal  dif- 
eafe. When  the  patient  cannot  bear  to  be  raifed  up  in  bed  with- 
out great  uneaiinefs,  it  is  a  bad  fymptom.  So  I  believe  is  deaf- 
nefs,  which  is  commonly  miilaken  for  (tupor.  See  Clafs  I.  2. 
5.  6.  And  when  the  dilatation  of  the  pupil  of  either  eye,  or  the 
fquinting  is  very  apparent^  or  the  pupils  of  both  eyes  much  dila- 
ted^ 


CLASS  I.  2.  3.  12.    OF  IRRITATION'.  87 

ted,  it  is  generally  fatal.  As  by  ftimulating  one  branch  of 
lymphatics  into  inverted  motion,  another  branch  is  liable  to  ab- 
forb  its  fluid  more  haftily  ;  fuppofe  ftrong  errhines,  as  com- 
mon tobacco  fnuffto  children,  or  one  grain  of  turpeth  mineral, 
(hydrargyrus  vitriolat'us),  mixed  with  ten  or  fifteen  grains  of  fu- 
gar,  were  gradually  blown  up  the  noftrils  ?  See  Clafs  I.  3.  2.  I. 
I  have  tried  common  fnuff  upon  two  children  in  this  difeafe  ; 
one  could  not  be  made  to  fneeze,  and  the  other  was  too  near  death 
to  receive  advantage.  Whpn  the  mercurial  preparations  have 

I  reduced  falivatiort,  I  believe  they  may  have  been  of  fbrvice,  but 
doubt  their  good  effect  otherwife.  In  one  child  I  tried  the 
ncture  of  digitalis ;  but  it  was  given  with  too  timid  a  hand, 
nd  too  late  in  the  difeafe,  to  determine  its  effects.  See  Seel. 
XXIX.  5.  9. 

As  all  the  above  remedies  generally  fail  of  fuccefs,  I  think 
frequent,  ahnolt  hourly,  (hocks  of  electricity  from  very  fmall 
charges  might  be  pafied  through  the  head  in  all  directions  with 
probability  of  good  event  ;  as  by  Volta's  rods  of  zinc  and  filver 
defcribed  in  Clafs  I.  2.  5.  5,  A  folution  of  hydrargyrus  muria- 
tus,  corrofive  fublimate  of  mercury  in  rectified  fpirit  of  wine, 
three  grains  to  an  ounce,  is  faid  to  produce  inftantaneous  and 
violent  falivation  ;  as  defcribed  in  Clafs  II.  1.5.  I.  on  Gonor- 
rhoea. Could  a  fmall  quantity  of  this  violent  ftimulus  be 
ufed  according  to  the  age  of  the  child  with  probable  good  ef- 
fect ?  Could  the  trephine  be  ufed  with  fafety  or  advantage 
•where  the  affected  fide  can  be  diftinguiihed  ?  See  Strabifmus, 
Clafs  I.  2.  5.  4.  When  one  eye  is  affected,  does  the  difeafe  ex- 
rft  in  the  ventricle  of  that  fide  ? 

The  following  extract  from  a  letter  of  Dr.  Beddoes  on  hydro- 
eephalus  internus,  is  well  worthy  to  be  attended  to. 

"  Mafter  L ,  aged  9  years,  became  fuddenly  ill  in  the 

night  about  a  week  before  I  faw  him.  On  the  day  before  the 
attack,  he  had  taken  opening  medicines,  and  had  bathed  after- 
wards. He  had  complained  of  violently  acute  pain  in  his  head, 
fhrieked  frequently,  ground  his  teeth  hard,  could  not  bear  to 
have  his  head  raifed  from  the  pillow,  and  was  torpid  or 
deaf.  His  tongue  was  white,  pulfe  1 10  in  the  evening  and  full. 
As  yet  the  pupil  of  the  eye  was  irritable,  and  he  had  no  ftrabif- 
mus.  He  had  been  bled  with  leeches  about  the  head,  and  blifter- 
ed.  I  directed  mercurial  inunction,  and  calomel  from  3  to  6  grains 
to  be  taken  at  firft  every  fix,  and  afterwards  every  three  hours. 
This  plan  produced  no  fenfible  effect,  and  the  patient  died  on 
the  1 8th  day  after  the  feizure.  He  had  convulfion-fits  two  days 
preceding  his  death,  and  the  well-known  fymptoms  of  hydro- 
cephalus  internus  all  made  their  appearance.  From  what  I  had 

feen 


S3  DISEASES  CLASS  I.  2. 3.  13, 

feen  and  read  of  this  difeafe,  I  believed  it  to  belong  to  inflamma- 
tions, and  at  an  earlier  period  I  ihould  be  tempted  to  bleed  as 
largely  as  for  pneumonia.  The  fluid  found  after  death  in  the  ven- 
tricles of  the  brain  I  impute  to  debility  of  the  abforbents  indu- 
ced by  inflammation.  My  reafons  are  briefly  thefe  :  i.  The 
acutenefs  of  the  pain.  2.  The  (late  of  the  pulfe.  In  the  above 
cafe  for  the  firft  9  or  10  days  it  did  not  exceed  no,  and  was 
full  and  ftrong.  3.  To  find  out  whether  any  febrile  alternations 
look  place,  Mailer  L.'s  feet  were  frequently  felt,  and  they  were 
found  at  times  cold,  and  at  other  times  of  a  dry  heat.  I  have 
many  times  feen  this  difeafe,  but  the  patients  were  too  young,  or 
too  far  advanced,  to  inform  me,  whether  they  had  chillnefs  iuc- 
ceeded  by  heat  at  its  onfet.  4.  The  diforders  to  which  the 
young  are  more  peculiarly  liable  afford  a  prefumption,  that  hy- 
clrocephalus  interims  is  an  inflammatory  difeafe  ;  and  this  is 
confirmed  by  the  regularity  of  the  period,  within  which  it  fin- 
iihes  its  courfe.  And  laftly,  does  not  happen  more  frequently 
than  is  fufpecled  from  external  injury  ? 

"  I  have  juft  now  been  well  informed,  that  Dr.  Rufh  has 
lately  cured  five  out  of  fix  patients  by  copious  bleedings.  I 
relate  here  the  reafons  for  an  opinion  without  pretending  to  a 
difcovery.  Something  like  this  doctrine  may  be  found  in  cer- 
tain modern  publications,  but  it  is  delivered  in  that  vague  and 
lUfFufe  ftyle,  which  I  trufl  your  example  will  banilh  from  medi- 
cal literature." 

To  this  idea  of  Dr.  Beddoes  may  be  added,  that  the  hydrocele 
generally  fucceeds  an  injury,  and  confequent  inflammation  of 
the  bag,  which  contains  it.  And  that  other  dropfies,  which 
principally  attend  inebriates,  are  confequent  to  too  great  action 
of  the  mucous  membranes  by  the  itimulas  of  beer,  wine,  and 
ipirits.  And  laftly,  that  as  thefe  cafes  of  hydrocephalus  end  fo 
fatally,  a  new  mode  of  treating  them  is  much  to  be  defired,  and 
deferves  to  be  ferioufly  attended  to. 

This  idea  of  inflammation  preceding  hydrocephalus  was  men- 
tioned by  Dr.  CVu'n,  and  afterwards  in  a  pamphlet  of  Dr.  Pat- 
erfon,  of  Dublin. 

13.  Afcites.  The  dropfy  of  the  cavity  of  the  abdomen  is 
known  by  a  tenfe  fwelling  of  the  belly  *,  which  does  not  found 
on  being  (truck  like  the  tympany  ;  and  in  which  a  fluctuation 
can  be  readily  perceived  by  applying  one  hand  expanded  on  one 
fide,  and  ftriking  the  tumour  on  the  other. 

Effufions  of  water  into  large  cavities,  as  into  that  of  the  abdo- 
men or  thorax,  or  into  the  ventricles  of  the  brain  or  pericardi- 
um, are  more  difficult  to  be  re-abforbed,  than  the  effufion  of 
fluids  into  the  cellular  membrane  •,  becaufe  one  part  of  this  ex- 

tenfivc 


CLASS  I.  2.  3.  14.        OF  IRRITATION. 

ten  five  fpongc-like  fyftem  of  cells,  which  connects  all 

of  the  body,  may  have  its   power  of  abforption  ii 
at  the  fame  time  that  fomc  other  part  of  it  may  flill  reta-.-i  UKIL 
power,  or  perhaps  poiTefs  it  in   an  increafed  degree  ;  and  as  all 
cells  communicate  with  each  other,  the  fluid,  which  abounds 
in  one  part  of  it,  can  be  transferred  to  another,  and  thus  be  re- 
forbed  into  the  circulation. 

[n  the  afcites,  cream  of  tartar  has  fometimes  been  attended 
fuccefs ;  a  dram  or  two  drams  are  given  every  hour  in  a 
lorning  till  it  operates,  and  this  is  to  be  repeated  for  feveral 
days  ;  but  the  operation  of  tapping  is  generally  applied  to  at  laft. 
Dr.  Sims,  in  the  Memoirs  of  the  Medical  Society  of  London, 
Vol.  III.  has  lately  propofed,  what  he  believes  to  be  a  more  fuc- 
cefsful  method  of  performing  this  operation,  by  making  a  punc- 
ture.with  a  lancet  in  the  fear  of  the  navel,  and  leaving  it  todif- 
charge  itfelf  gradually  for  feveral  days,  without  introducing  a 
canula,  which  he  thinks  injurious,  both  on  account  of  the  too 
fudden  emiffion  of  the  fluid,  and  the  danger  of  wounding  or  ftim- 
ulating  the  vifcera.  This  operation  I  have  twice  known  per- 
formed with  lefs  inconvenience,  and  I  believe  with  more  beitgiit 
to  the  patient,  than  the  common  method. 

After  the  patient  has  been  tapped,  fome  have  tried  injections 
into  the  cavity  of  the  abdomen,  but  hitherto  I  believe  with  ill 
event.  Nor  are  experiments  of  this  kind  very  promifmg  of  fuc- 
cefs. Firft,  becaufe  the  patients  are  generally  much  debilitated, 
jnofl  frequently  by  fpirituous  potation,  and  have  generally  a  dif- 
eaie  of  the  liver,  or  of  other  vifcera.  And  fecondly,  becaufe 
the  quantity  of  inflammation,  necefiary  to  prevent  future  fecretion 
of  mucus  into  the  cavity  of  the  abdomen,  by  uniting  the  perito- 
neum with  the  interlines  or  mefentery,  as  happens  in  the  cure 
of  the  hydrocele,  would  I  fuppofe  generally  deflroy  the  patient, 
either  immediately,  or  by  the  confequence  of  fuch  adhefions. 

This  however  is  not  the  cafe  in  refpect  to  the  dropfy  of  the 
4)varium,  or  in  the  hydrocele. 

14.  Hydrops  thoracis.  The  dropfy  of  the  cheft  commences 
with  lofs  of  fle(h,  cold  extremities,  pale  countenance,  high  col- 
oured urine  in  fmall  quantity,  and  general  debility,  like  many 
other  dropfies.  The  patient  next  complains  of  numbnefs  in  the 
arms,. especially  when  elevated,  with  pain  and  difficulty  of  fwal- 
lowing,  and  an  abfolute  impombility  of  lying  down  for  a  few 
minutes,  or  with  fudden  darting  from  fleep,  with  great  difficulty 
of  breathing  and  palpitation  of  his  heart.  It  is  often  confound- 
ed with  anafarca  pulmonum,  which  fee. 

The  numbnefs  of  the  arms  is  probably  owing  more  frequent- 
ly to  the  increafed  action  of  the  pectoral  mufcles  in  refpiration, 
VOL.  II.  N  whence 


<^  DISEASES  CLASS  I.  at.  3.  14; 

whence  they  are  lefs  at  liberty  to  perform  other  offices,  than  to 
the  connexion  of  nerves  mentioned  in  Seel:.  XXIX.  5.  2.  The 
difficulty  of  fwallowing  is  owing  to  the  comprefiion  of  the 
cefophagus  by  the  lymph  in  the  cheft ;  and  the  impoffibility  o£ 
breathing  in  a  horizontal  pofture  originates  from  this,  that  if  any 
parts  of  the  lungs  muft'be  rendered  ufelefs,  the  inability  of  the 
extremities  of  them  muft  be  lefs  inconvenient  to  refpiration  j 
fmce  if  the  upper  parts  or  larger  trunks  of  the  air-veflels  mould 
be  rendered  ufelefs  by  the  compreffion  of  the  accumulated  lymph, 
the  air  could  not  gain  admitance  to  the  other  parts,  and  the  ani- 
mal muft  immediately  perifh. 

If  the  pericardium  is  the  principal  feat  of  the  difeafe,  the 
pulfe  is  quick  and  irregular.  If  only  the  cavity  of  the  thorax  is 
hydropic,  the  pulfe  is  not  quick  nor  irregular. 

If  one  fide  is  more  affected  than  the  other,  the  patient  leans 
moft  that  way,  and  has  more  nurnbnefs  in  that  arm. 

The  hydrops  thoracis  is  cliftinguifhed  from  the  anafarca  pul- 
monum,  as  the  patient  in  the  former  cannot  lie  down  half  a  min- 
ute ;  in  the  latter  the  difficulty  of  breathing,  which  occafions 
him  to  rife  up,  comes  on  more  gradually ;  as  the  tranfition  of 
the  lymph  in  the  cellular  membrane  from  one  part  to  another  of 
it  is  flower,  than  that  of  the  eiTufed  lymph  in  the  cavity  of  the 
cheft. 

The  hydrops  thoracis  is  often  complicated  with  fits  of  con- 
vulfive  breathing  ;  and  then  it  produces  a  difeafe  for  the  time 
very  fimilar  to  the  common  periodic  afthma,  which  is  perhaps 
owing  to  a  temporary  anafarca  of  the  lungs  ;  or  to  an  impaired, 
venous  abforption  in  them.  Thefe  exacerbations  of  difficult 
breathing  are  attended  with  cold  extremities,  cold  breath,  cold 
tongue,  upright  pofture  with  the  mouth  open,  and  a  defire  of 
cold  air,  and  a  quick,  weak,  intermittent  pulfe,  and  contracted 
hands. 

Thefe  exacerbations  recur  fometimes  every  two  or  three  hours, 
and  are  relieved  by  opium,  a  grain  every  hour  for  two  or  three 
dofes,  with  ether  about  a  dram  in  cold  water  5  and  feem  to  be  a 
convulfion  of  the  mufcles  of  refpiration  induced  by  the  pain  of  the 
dyfpncea.  As  in  Clafs  III.  I.  I.  9. 

M.  M.   A  grain  of  dried  fquill,  and  a   quarter  of  a  grain  of 
blue  vitriol  every  hour  for  fix  or  eight  hours,  unlefs  it  vomit  or 
purge.     A  grain  of  opium.     Blifters.     Calomel   three   grains 
every   third  day,  with  infufion  of  fenna.     Bark.     Chalybeates. 
Pim£hire  in  the  fide. 

Can  the  fluctuation  in  the  cheft  be  heard  by  applying  the  ear 
to  the  fide,  as  Hippocrates  aflerts  ?  Can  it  be  felt  by  the  hand  or 
by  the  patient  before  the  difeafe  is  too  great  to  admit  of  cure  by 

the 


CLASS  I.  2.  3.  15.     OF  IRRITATION. 

paracenrefis  ?  Does  this  dropfy  of  the  cheft  often  c< 

!peripneumony  ?  Is  it  ever  cured  by  making  the  p 
•    by  tincture  of  digitalis  ?  Could  it  be  cured,  if  on  one  fide  only, 
i  by  the  operation  of  puncture  between  the  ribs,  and  afterwards 
by  inflaming  the  cavity  by  the  admiffion  of  air  for  a  time,  like 
cure  of  the  hydrocele  ;  the  pleura  afterwards  adhering  whol- 
ly to  that  lobe  of  the  lungs,  ib  as  to  prevent  any  future  effuiioa 
of  mucus  ? 

I  fufpecl:  the  anafarca  of  the  lungs,  as  well  as  the  hydrops 
thoracis,  to  be  molt  frequently  difeaies  of  thofe  membranes  on- 
fy,  and  noc  to  depend  on  the  general  paralyfis  of  the  abforbent 
fyilem  ;  and  that  they  are  then  not  accompanied  with  fwelled 
kgs,  till  the  patient  becomes  univerfally  weak  ;  and  that  they 
have  for  their  caufe  a  rheumatic  or  gouty  peripneumony  or  pleu- 
rify  ;  that  is,  that  the  lungs  or  pleura  have  been  inflamed  from 
eir  fympathy  with  fome  other  vifcus,  and  have  depofited  much 
agulable  lymph  on  the  furface  of  their  inflamed  membranes, 
hich  could  not  readily  become  abforbed,  and  has  thus  caufed 
the  dropfy  of  the  cavity  of  the  cheft,  like  the  coagulable  lymph 
cr  chalky  matter  left  after  the  gout  and  rheumatifm  in  other 
parts  ;  or  that  the  cellular  membrane  of  the  lungs  becomes  fill- 
ed with  a  fluid  from  the  prefent  inaction  of  their  abforbent  vef- 
fels,  which  had  previoufly  been  excited  too  violently  ;  and  that 
the  anafarca  of  the  lungs  is  thus  produced  like  the  anafarca. 
•which,  frequently  in  weak  conftitutions,  exifts  after  the  gout  in 
the  feet  and  knees,  and  after  rheumatic  inflammations  of  the 
joints.  See  Peripneumonia,  Clafs  II.  1.2.  4.  whence  it  appears, 
•why  the  hydrops  thoracis  and  anafarca  pulmonum  fo  generally 
occur  in  gouty  conftitutions. 

15.  Hydrops  ovaru.  Dropfy  of  the  ovary  is  another  encyfted 
dropfy,  which  feldom  admits  of  cure.  It  is  diftinguilhed  .from 
afcites  by  the  tumour  and  pain,  efpecially  at  the  beginning,  oc- 
cupying one  fide,  and  the  fluctuation  being  iefs  diftinclly  per- 
ceptible- When  it  happens  to  young  fubjects  it  is  Iefs  liable  to 
be  miftaken  for  afcites.  Jt  affects  women  of  all  ages,  either 
named  or  virgins  ;  and  is  produced  by  cold,  fear,  hunger,  bad 
food,  and  other  debilitating  caufes.  I  faw  an  elegant  young  la- 
dy, who  was  fhortly  to  have  been  married  to  a  fenfible  man,  with 
great  profpeft  of  happinefs  ;  who,  on  being  overturned  in  a 
chaife  in  the  night,  and  obliged  to  walk  two  or  three  miles  in 
wet,  cold,  and  darknefs,  became  much  indifpofed,  and  gradually 
afflicted  with  a  fwelling  and  pain  on  one  fide  of  the  abdomen  j 
which  terminated  in  a  dropfy  of  the  ovary,  and  deftroyed  her  in. 
two  or  three  years.  Another  young  woman  I  recollect:  feeing> 
was  about  feventeen,  and  being  of  the  very  inferior  clafs 


DISEASES  CLASS  I.  2.  3.  i& 

of  people,  fee'med  to  have  been  much  weakened  by  the  hardfhip 
of  a  cold  floor,  and  little  or  no  bed,  with  bad  food  ;  and  who  to 
thefe  evils  had  to  bear  the  unceafmg  obloquy  of  her  neighbors, 
and  the  perfecution  of  parifh  officers. 

The  following  is  abilratied  from  a  letter  of  my  friend  Mr. 
Power,  furgeon,  at  Bofworth  in  Leicefterfhire,  on  examining  the 
body  of  an  elderly  lady  who  died  of  this  difeafe,  March  29, 
1793.  "  On  opening  the  abdomen  1  found  a  large  cyft  attach-' 
ed  to  the  left  ovarium  by  an  elaftic  neck  as  thick  as  the  little  rin- 
ger, and  fo  callous  as  not  to  admit  of  being  feparated  by  fciiTars 
without  confiderable  difficulty.  The  fub(tance  of  the  cyft  had 
an  appearance  much  refembling  the  gravid  uterus  near  the  full 
period  of  geftation,  and  was  as  thick.  It  had  no  attachment  to 
the  peritoneum,  or  any  of  the  vifcera,  except  by  the  hard  callous 
neck  I  have  mentioned  ;  fo  that  the  blood  muft  with  difficulty 
have  been  circulated  through  it  for  fome  time.  Its  texture  was 
extremely  tender,  being  eafily  perforated  with  the  finger,  was  of 
a  livid  red  colour,  and  evidently  in  a  fphacelated  ftate.  It  con- 
tained about  two  gallons  of  a  fluid  of  the  colour  of  port  wine, 
without  any  greater  tenacity.  It  has  fallen  to  my  lot  to  have 
opened  two  other  patients,  whofe  deaths  were  occasioned  by  en- 
cyfted  dropfy  of  the  ovarium.  In  one  of  thefe  the  ovarium  was 
much  enlarged  with  eight  or  ten  cyfts  on  its  furface,  but  there 
was  no  adhefion  formed  by  any  of  the  cyfts  to  any  other  part ; 
nor  had  the  ovarium  formed  any  adhefion  with  the  peritoneum, 
though  in  a  very  difeafed  ftate.  In  the  other  the  difeafe  was 
more  fimple,  being  only  one  cyft,  without  any  attachment  but 
to  the  ovarium. 

"  As  the  ovarium  is  a  part  not  neceflary  to  life,  and  dropfies 
of  this  kind  are  fo  generally  fatal  in  the  end,  I  think  I  mall  be 
induced,  notwithstanding  the  hazard  attending  wounds,  which 
penetrate  the  cavity  of  the  abdomen,  to  propofe  the  extirpation 
of  the  difeafed  part  in  the  firft  cafe,  which  occurs  to  me,  in 
which  I  can  with  precifion  fay,  that  the  ovarium  is  the  feat  of 
the  difeafe,  and  the  patient  in  other  refpecls  tolerably  healthy  ; 
as  the  cavity  of  the  abdomen  is  often  opened  in  other  cafes 
without  bad  confequences." 

An  argument,  which  might  further  countenance  the  opera- 
tion thus  propofed  by  Mr.  Power,  might  be  taken  from  the  dif- 
eafe frequently  affecting  young  perfons  ;  from  its  being  gener- 
ally in  thefe  fubjecls  local  and  primary  \  and  not  like  the  afcites, 
produced  or  accompanied  with  other  difeafed  vifcera  ;  and  laft- 
Jy,  as  it  is  performed  in  adult  quadrupeds,  as  old  fows,  with 
fafety,  though  by  awkward  operators. 

16,  Anafarca  pulmcnum*     The  dropfy  of  the  cellular  mem- 
brane 


CLASS  I.  2.  3.  i o.       OF  IRRITATION.  ^ 

brane  of  the  lungs  is  ufually  connected  with  that  of  the  other 
parts  of  the  fyftem.  As  the  cells  of  the  whole  cellular  mem- 
brane communicate  with 'each  other,  the  mucilaginous  fluid, 
which  remains  in  any  part  of  it  for  want  of  due  abforption,  finks 
down  to  the  moft  depending  cells ;  hence  the  legs  f well,  though 
the  caufe  of  the  dileafe,  the  deficiency  «f  abforption,  may  be  in 
other  parts  of  die  fyftem.  The  lungs  however  are  an  exception 
to  this,  fince  they  are  fufpended  in  the  cavity  of  the  thorax,  and 
have  in  confequence  a  depending  part  of  their  own. 

The  anafarca  of  the  lungs  is  known  by  the  difficulty  of  ref- 
piration  accompanied  with  fwelled  legs,  and  with  a  very  irregu- 
lar pulfe.  This  laft  circumftance  has  generally  been  afcribed 
to  a  dropfy  at  the  fame  time  exifting  in  the  pericardium,  but  is 
more  probably  owing  to  the  difficult  paflage  of  the  blood  through 
the  lungs ;  becaufe  I  found  on  diffecHon,  in  one  inftance,  that 
the  moft  irregular  pulfe,  which  I  ever  attended  to,  was  owing  to 
very  extenfive  adhefion  of  the  lungs  •,  infomuch  that  one  lobein- 
tirely  adhered  to  the  pleura ;  and  fecondly,  becaufe  this  kind  of 
r.Topfy  of  the  lungs  is  fo  certainly  removed  for  a  time  along  with 
the  anafarca  of  the  limbs  by  the  ufe  of  digitalis. 

This  medicine,  as  well  as  emetic  tartar,  or  fquill,  when  given 
fo  as  to  produce  fickncfs,  or  naufea,  or  perhaps  even  without 
producing  either  in  any  perceptible  degree,  by  affe&ing  the  lym- 
phatics of  the  ftomach,  fo  as  either  to  invert  their  motion,  or  to 
weaken  them,  increafes  by  reverie  fympathy  the  action,  and  con- 
iequent  abforbent  power  of  thefe  lymphatics,  which  open  into 
the  cellular  membrane.  But  as  thefe  medicines  feldom  fucceed 
in  producing  an  abforption  of  thofe  fluids,  which  ftagnate  in 
the  larger  cavities  of  the  body,  as  in  the  abdomen,  or  cheft,  and 
do  generally  fucceed  in  this  difficulty  of  breathing  with  irregu- 
lar pulfe  above  defcribed,  I  conclude  that  it  is  not  owing  to  an 
effufijon  of  lymph  into  the  pericardium,  but  fimply  to  an  anafar- 
ca of  the  lungs. 

M.  M.  Digitalis.  See  Art.  V.  2.  I.  2.  and  IV.  2.  3.  7. 
Tobacco.  Squill.  Emetic  tartar  (antimonium  tartarizatum). 
Then  Sorbentia.  Chalybeates.  Opium  half  a  grain  twice  a 
day.  Raifm  wine  and  water,  or  other  wine  and  water,  is  pre- 
ferred to  the  fpirit  and  water,  which  thefe  patients  have  general- 
ly been  accuitomed  to. 

I  have  feen  two  cafes,  which  were  efteemed  to  be  hydrotho- 

rax,  but  which  I  believed  to  be  anafarca  pulmonum,  though  they 

were  attended  with  irregular  pulfe  ;  for   I  do  not  undciTcand, 

why  an  irregularity  of  pulfe  mould  be  occafioned  by  water  in 

pericardium   any   more  than  by  water  in  the  lungs,  or   by 

any 


$4  DISEASES  CLASS  1. 2. 3.  17; 

any  other  obftruc"lion  to  the  circulation.  See  Clafs  IV.  2.  i.  18. 
Pulfus  intermittens,  and  Palpitatio  cordis. 

In  both  thefe  cafes  the  patients  could  not  fleep  above  one  min- 
ute at  a  time  ;  which  I  aicribed  to  the  debility  of  the  action  of 
the  heart  compared  with  the  refillance  to  the  circulation,  and 
that  fome  voluntary  exertion  became  neceflary  to  carry  on  the 
circulation,  which  does  not  exift  in  fleep.  See  Clafs  I.  2.  I.  3. 
Somnus  interruptus. 

Thefe  two  cafes  of  patients  about  fixty  years  of  age  are  here 
mentioned  from  a  curious  circumftance,  that  both  the  patients 
became  in  fome  degree  infane  after  being  relieved  by  the  tinc- 
ture of  digitalis  taken  to  the  quantity  of  thirty  drops  three  or  four 
times  a  day  for  two  or  three  days ;  and  remained  in  a  flight  de- 
gree of  infanity  for  fome  months,  and  then  as  this  increafe  of 
voluntary  exertion  ceafed,  they  again  became  afflicted  with  the 
anafarca  pulmonum,  and  fwelling  of  the  legs,  and  this  repeat- 
edly for  two  or  three  years.  I  have  before  feen  a  common  an- 
afarca repeatedly  cured  by  infanity  for  a  year  or  two,  and  two 
fevers  I  have  feen  attended  with  great  debility  cured  by  the  ac- 
cefs  of  infanity,  which  was  called  delirium  by  the  attendants  j 
and  I  lately  witnefled  the  prefent  cure  of  what  was  believed  to 
be  confumption  by  the  accefs  of  infanity.  All  which  were 
probably  effected  by  the  increafed  energy  of  fome  parts  of  the 
fyftem  owing  to  the  addition  of  volition  to  the  fenforial  powers 
of  irritation  or  afTociatiorL 

The  ufual  caufe  of  anafarca  is  from  a  difeafed  liver,  and  hence 
it  moft  frequently  attends  thofe,  who  have  drunk  much  ferment- 
ed or  fpirituous  liquors  ;  but  I  fufpecl  that  there  is  another 
caufe  of  anafarca,  which  originates  from  the  brain  ;  and  which 
is  more  certainly  fatal  than  that,  which  originates  from  a  difeaf- 
ed liver.  Thefe  patients,  where  the  anafarca  originates  from,  or 
commences  in,  the  brain,  have  not  other  fymptoms  of  difeafed 
Jiver  ;  have  lefs  difficulty  of  breathing  at  the  beginning  j  and 
hold  themfelves  more  upright  in  their  chair,  and  in  walking.  In 
this  kind  of  dropfy  I  fufpecl  the  digitalis  has  lefs  or  no  efre6t ; 
as  it  particularly  increafes  the  abforption  from  the  lungs. 

17.  Obefitas.  Corpulency  may  be  called  anafarca  or  dropfy 
of  fat,  fmce  it  mult  be  owing  to  an  analogous  caufe;  that  is,  to 
the  deficient  abforption  of  fat  compared  to  the  quantity  fecreted 
into  the  cells  which  contain  it.  See  Clafs  II.  i .  i .  4. 

The  method  of  getting  free  from  too  much  fat  without  any 
injury  to  theconftitution,  confifls,  firft,  in  putting  on  a  proper 
bandage  on  the  belly,  lo  that  it  can  be  tightened  or  relaxed  with 
eafe,  as  a  tightifh  under  waiflcoat,  with  a  double  row  of  buttons. 
Xhis  is  to  comprefs  the  bowels  and  increafe  their  abforption  5 

and 


GLASS  I.  a.  3.  i8L        OF  IRRITAtlON.  93 

and  it  thus  removes  one  principal  caufe  of  corpulency,  which  b 
the  loofenefs  of  the  (kin.  Secondly,  he  fliould  omit  one  entire 
meal,  as  fupper  ;  by  this  long  abftinence  from  food  the  abforb- 
ent  fyftem  will  aft  on  the  mucus  and  fat  with  greater  energy. 
Thirdly,  he  fliould  drink  as  little  as  he  can  with  eafe  to  his  fen- 
fations  ;  fmce,  if  the  abforbents  of  the  ftomach  and  bowels  fup- 
ply  the  blood  with  much,  or  perhaps  too  much,  aqueous  fluid, 
the  abforbents  of  the  cellular  membrane  will  aft  with  lefs  ener- 
gy. Fourthly,  he  fhould  ufe  much  fait  or  falted  meat,  which 
will  increafe  the  perfpiration  and  make  him  thirfby  ;  and  if  he 
bears  this  thirft,  the  abforption-  of  his  fat  will  be  greatly  increaf- 
ed,  as  appears  in  fevers  and  dropfies  with  thirft ;  this  I  believe  to 
be  more  efficacious  than  foap.  Fifthly,  he  may  ufe  aerated  al- 
kaline water  for  his  drink,  which  may  be  fuppofed  to  render  the 
fat  more  fluid, — or  he  may  take  foap  in  large  quantities,  whiclt 
will  be  decompofed  in-  the  ftomach.  Sixthly,  ihort  reft,  and 
conftant  exercife. 

Vinegar  has  been  faid  to  reduce  corpulency,  but  as  it  con- 
tains much  vinous  fpirit,  it  may  injure  the  general  health  with- 
out previoufly  inducing  leannefs.  Perhaps  cryftals  of  tartar 
might  fucceed  better  ufed  daily  in  water  at  meals. 

The  moft  efficacious  method  of  reducing  the  quantity  of  the 
fat  I  fufpeft  may  be  by  the  life  of  the  tincture  of  digitalis  in 
fmall  quantity,  as  twenty  or  thirty  drops  twice  a  day,  as  direct  - 
ed  in  Article  IV.  2.  3.  7.  As  the  effect  of  this  medicine,  when 
given  in  greater  quantity,  as  in  forty  drops  twice  or  thrice  a  day 
in  hydrothorax  or  general  anafarca,evidently  confifts  in  weaken- 
ing the  natural  actions  of  the  ftomach,  perhaps  by  previoufly 
ftimulating  that  vifcus  too  violently  ;  in  confequence  the  heart 
and  arteries  aft  lefs  powerfully  from  their  fympathy  with  the 
ftomach  ;  and  the  capillary  vefTels,  and  abforbents,  act  more 
powerfully  in  confequence  of  the  lefs  expenditure  of  fenforial 
power  by  the  inert  action  of  the  heart  and  arteries  ;  and  will 
confequently  ablbrb  the  accumulated  fat  from  the  cellular  mem- 
brane, as  explained  in  Supplement  I.  12.  10. 

1 8.  Splenis  tumor.  Swellings  of  the  fpleen,  or  in  its  vicinity, 
are  frequently  preceived  by  the  hand  in  intermittents,  which  are 
called  Ague-cakes,  and  feem  owing  to  a  deficiency  of  abforption 
in  the  affected  part. 

Mr.  Y ,  a  young  man  about  twenty-five  years  of  age, 

who  lived  intemperately,  was  feized  with  an  obftinate  intermit- 
tent, which  had  become  a  continued  fever  with  ftrong  pulfe,  at- 
tended with  daily  remiffion.  A  large  hard  tumour  on  the  left 
fide,  on  the  region  of  the  fpleen,  but  extending  much  more 
downward,  was  fo  diflinftly  preceptible,  that  one  feemed  to  get 


one  s 


Qfi  DISEASES  CLASS  1 2. 3.  194 

one's  fingers  under  the  edge  of  it,  much  like  the  feel  of  the  brawn 
or  fhield  on  a  boar's  (boulder.  He  was  repeatedly  bled,  and 
purged  with  calomel,  had  an  emetic,  and  a  bliiter  on  the  part, 
without  diminiihing  the  tumour  ;  after  fome  time  he  took  the 
Peruvian  bark,  and  flight  dofes  of  chalybeates,  and  thus  became 
free  from  the  fever,  and  went  to  Bath  for  feveral  weeks,  but  the 
tumour  remained.  This  tumour  I  examined  every  four  or  five 
years  for  above  thirty  years.  His  countenance  was  pale,  and  to- 
wards the  end  of  his  life  he  differed  much  from  ulcers  on  his 
legs,  and  died  about  fixty,  of  general  debility  ;  like  many  others 
who  live  intemperately  in  refpecl  to  the  ingurgitation  of  fer- 
mented or  fpirituous  liquors. 

As  this  tumour  commenced  in  the  cold  fit  of  an  intermittent 
fever,  and  was  not  attended  with  pain,  and  continued  fo  long 
without  endangering  his  life,  there  is  reafon  to  believe  it  was 
fimply  occafioned  by  deficient  abforption,  and  not  by  more  en- 
ergetic action  of  the  veffels  which  conftitute  the  fpleen.  Sec 
ClafsII.  i.  2.  13. 

M.  M.  Veneiedion.  Emetic,  cathartic  with  calomel ;  then 
forbentia,  chalybeates,  Peruvian  bark. 

19.  Genii,  tumor  albus.     White  fwelling  of  the  knee,  is  owing 
to  deficient  abforption  of  the  lymphatics  of  the   membranes  in- 
cluding the  joint,  or  capfular  ligaments,  and  fometimes  perhaps 
of  the  gland  which  fecretes  the  fynovia  -,  and  the  ends  of  the  bones 
are  probably  affected  in  confequence. 

I  faw  an  inftance,  where  a  cauflic  had  been  applied  by  an 
empyric  on  a  large  white  fwelling  of  the  knee,  and  was  told,  that 
a  fluid  had  been  difcharged  from  the  joint,  which  became  an- 
chylofed,  and  healed  without  lofs  of  the  limb. 

M.  M.  Repeated  bliilers  on  the  part  early  in  the  difeafe  are 
faid  to  cure  it  by  promoting  abforption  ;  faturnine  folutions  ex- 
ternally are  recommended.  Bark,  animal  charcoal,  as  burnt 
fponge,  opium  in  fmall  dofes.  FricYion  with  the  hand.  Four 
or  fix  leeches  applied  on  or  beneath  the  knee  alternately  with  the 
blifters,  and  a  cupping  glafs  put  over  the  wounds  made  by  the 
leeches  are  much  recommended. 

20.  Bronchocele.     Swelled  throat.     An    enlargement  of  the 
thyroid  glands,    faid  to  be   frequent   in  mountainous  countries, 
where  river  water  is  drunk,  which  has  its  fource  from  difiblving 
fnovvs.     This   idea  is   a  very  ancient  one,  but  perhaps  not  on 
that  account    to  be   the  more  depended  upon,   as  authors  copy 
one  another.     Tumidum  guttur  quis  miratur  in  Alpibus,  feems 
to  have  been  a  proverb  in  the  time   of  Juvenal.     The  inferior 
people  of  Derby  are  much  fubject   to  this  difeafe,  but  whether 
more  fo  than  other  populous  towns,  I  can  not  determine  ,  certain 

it 


CLASS  I.  2.  3.  2i.        OF  IRRITATION.  97 

it  is,  that  they  chiefly  drink  the  water  of  the  Dsrxvent,  which 
arifes  in  a  mountainous  country,  and  is  very  frequently  blacken- 
ed as  it  paries  through  the  moraiTes  near  its  fourcc  ;  and  is  gen- 
erally of  a  darker  colour,  and  attended  with  a  whiter  foam,  than 
the 'Trent,  into  which  it  falls  ;  the  greater  quantity  and  white- 
nefs  of  its  froth  I  fuppofe  may  be  owing  to  the  vifcidity  com- 
municated to  it  by  the  colouring  matter.  The  lower  parts  of 
the  town  of  Derby  might  be  eafdy  fupplied  with  fpring  water 
from  St.  Alkmond's  well  •,  or  the  whole  of  it  from  the  abun- 
dant fprings  near  Bowbridge  :  the  water  from  which  might  be 
conveyed  to  the  town  in  hollow  bricks,  or  clay-pipes,  at  no  very- 
great  expence,  and  might  be  received  into  frequent  refervoirs 
•with  pumps  to  them  ;  or  laid  into  the  houfes. 

M.  M.  Twenty  grains  of  burnt  fponge  with  ten  of  nitre  made 
with  mucilage  into  lozenges,  and  permitted  to  diffblve  flowly  un- 
der the  tongue  twice  a  day,  is  averted  to  cure  in  a  few  months  , 
perhaps  other  animal  charcoal,  as  candle-fhuffs,  might  do  the 
fame. 

I  have  direcled  in  the  early  date  of  this  difeafe  a  mixture  of 
common  fait  and  water  to  be  held  in  the  mouth,  particularly 
under  the  tongue,  for  a  few  minutes,  four  or  fix  times  a  day  for 
many  weeks,  which  has  fometimes  fucceeded,  the  fait  and  water 
33  then  fpit  out  again,  or  in  part  fwallowed.  Externally  vinegar 
of  fquills  has  been  applied,  or  a  mercurial  plafter,  or  fomentations 
of  acetated  ammoniac  ;  or  ether.  Some  empyrics  have  applied 
cauftics  on  the  bronchocele,  and  fometimes,  I  have  been  told, 
with  fuccefs  ;  which  (hould  certainly  be  ufed  where  there  is 
danger  of  fuffbcation  from  the  bulk  of  it.  One  cafe  I  faw,  and 
one  I  was  well  informed  of,  where  the  bronchocele  was  cured  by 
burnt  fponge.  and  a  he£ltc  fever  fupcrvened  with  colliquative 
fweats  ;  but  I  do  not  know  the  final  event  of  either  of  them. 

De  Haen  affirms  the  cure  of  branchocele  to  be  effected  by 
flowers  of  zinc,  calcined  egg-fhells,  and  fcarlet-cloth  burnt  to- 
gether in  a  clofe  crucible,  which  was  tried  wirh  fuccefs,  as  he. 
aiTured  me,  by  a  late  lamented  phyfician,  my  friend,  Dr.  Small 
of  Birmingham  ;  who  to  the  cultivation  of  modern  fciences  add- 
ed the  integrity  of  ancient  manners  ;  who  in  clearnefs  of  head, 
and  benevolence  of  heart,  had  few  equal?,  perhaps  no  fuperiors. 

21.  Scrofula.  Kind's  evil  is  known  by  tumours  of  the  lym- 
phatic glands,  particularly  of  the  neck.  The  upper  lip,  and  di- 
vifion  of  the  noftrils  are  f-.vdled,  wirh  a  florid  countenance,  a 
fmopth  fkin,  and  a  tumid  abdomen.  Cullen.  The  abf 
ids  in  their  courfe  to  the  veins  in  the  fcrofuln  are  arrefted  in  tli- 
lymphatic  or  conglobate  glands  ;  which  fwell,  and  after  a  trreac 
length  of  time,  inflame  and  fuppurate.  Materials  of  a  pec 

VOL.  II.  O 


9S  DISEASES  GLASS  I.  2.  3. 21', 

kind,  as  the  variolous  and  venereal  matter,  when  abforbed  in  a 
wound,  produce  this  torpor,  and  confequent  inflammation  of 
thofe  lymphatic  glands,  where  they  firft  arrive,  as  in  the  axilla 
and  groin.  There  is  reafon  to  fufpeft,  that  the  tonftls  frequent- 
ly become  inflamed,  and  fuppurate  from  the  matter  abibrbed 
from  carious  teeth  ;  and  I  faw  a  young  lady,  who  had  both  the 
axillary  glands  fwelled,  and  which  fuppurated  j  which  was  believ- 
ed to  nave  been  caufed  by  her  wearing  a  pair  of  new  green  gloves 
for  one  day,  when  me  had  perfpired  much,  and  was  much  ex- 
haufted  and  fatigued  by  walking  •,  the  gloves  were  probably  dyed 
in  a  folution  of  verdker. 

Thefe  indolent  tumours  of  the  lymphatic  glands,  which  con- 
ftitute  the  fcrofula,  originate  from  the  inirritability  of  thole 
glands  ;  which  therefore  fooner  fall  into  torpor  after  having 
been  ftimulated  too  violently  by  fome  poifonous  material ;  as 
the  mufcles  of  enfeebled  people  fooner  become  fatigued,  and 
ceafe  to  aft,  when  exerted,  than  thofe  of  ftronger  ones.  On  the 
fame  account  thefe  fcrofulous  glands  are  much  longer  in  acquir- 
ing increafe  of  motion,  after  having  been  ftimulated  into  inac- 
tivity, and  either  remain  years  in  a  fiate  of  indolence,  or  fup- 
purate with  difficulty,  and  fometirnes  only  partially. 

The  difference  between  fcrofulous  tumours,  and  thofe  before 
defcribed,  confifts  in  this  ;  that  in  thofe  either  glands  of  differ- 
ent kinds  were  difeafed,  or  the  mouths  only  of  the  lymphatic 
glands  were  become  torpid  ;  whereas  in  fcrofula  the  conglobate 
glands  themfelves  become  tumid,  and  generally  fuppurate  after 
a  great  length  of  time,  when  they  acquire  new  fenfibility. 
See  Sea.  XXXIX.  4.  5. 

Thefe  indolent  tumours  may  be  brought  to  fuppurate  fome- 
times  by  paffing  electric  {hocks  through  them  every  day  for  two 
or  three  weeks,  as  I  have  witnefled.  It  is  probable,  that  the  al- 
ternate application  of  fnow  or  iced  water  to  them,  till  they  be- 
come painfully  cold,  an^l  then  of  warm  flannel  or  warm  watery 
frequently  repeated,  might  reftore  their  irritability  by  accumula- 
tion of  fenfoml  power  ;  and  thence  either  facilitate  their  difper- 
fioii,  or  occafion  them  to  fuppurate.  See  Clafs  II.  i.  4.  13. 

This  difeafe  is  very  frequent  amongft  the  children  of  the  poor  in 
large  towns,  who  are  in  general  ill  fed,  ill  lodged,  and  ill  clothed  ; 
and  who  are  further  weakened  by  eating  much  fait  with  their 
fcanty  meal  of  infipid  vegetable  food,  which  is  feldom  of  better 
quality  than  water  gruel,  with  a  little  coarfe  bread  in  it.  See 
diarrhoea  of  infants,  Clafs  I.  I.  2.  5.  Scrofulous  ulcers  are 
difficult  to  heal,  which  is  owing  to  the  deficiency,  of  abforption 
on  their  pale  and  flabby  furfaces,  and  to  the  general  inirritability 
of  the  fyftem.  See  Clafs  I.  i.  3.  13. 

M.  M.  Plentiful 


CLASS  I.  2.  3.  22.       OF  IRRITATION.  99 

M.  M.  Plentiful  diet  of  flefli  meat  and  vegetables  with  fmall 
beer.  Opium,  from  a  quarter  of  a  grain  to  half  a  grain  twice 
a  day.  Sorbentia.  Tincture  of  digitalis,  thirty  drops  twice  a 
clay.  Externally  fea-bathing,  or  bathing  in  fait  and  water,  one 
pound  to  three  gallons,  made  warm.  The  application  of  Peru- 
vian bark  in  fine  powder,  feven  parts,  and  white  lead  (cerufla), 
in  fine  powder  one  part,  mixed  together  and  applied  on  the  ul- 
cers in.  dry  powder,  by  means  of  lint  and  a  bandage,  to  be  renew- 
ed every  day.  Or  very  fine  powder  of  calamy  alone,  lapis  ca- 
laminaris.  If  powder  of  manganefe  ?  See  Clafs  II.  i.  4.  13. 

22.  Sclrrhus.     After  the  abforbent  veins  of  a  gland  ceafe  to 
perform  their  oiHce,  if  .the  feeerning  arteries  of  it  continue  to 
act  fome  time  longer,  the  fluids  are  pufhed  forwards,  and  ftag- 
nate  in  the  receptacles  or  capillary  vefiels  of  the  gland  ;  and  the 
thinner  part  of  them  only  being  refumedby  the  abforbent  fyftem 
of  the  gland,  a  hard  tumour  gradually  fucceeds  ;  which  contin- 
ues like  a  Hfelels  mafs,  till  from  fome  accidental  violence  it  gains 
fenfibility,  and  produces  cancer,  or    fuppurates.     Of  this   kind 
are  the  fcirrhus  glands  of  the  breafts,  of  the  lungs,  of  the  mefen- 
tery,  and  the  fcrofulous  tumours  about  the  neck  and  the  bron- 
chocele. 

Another  feat  of  fcirrhus  is  in  the  membranous  parts  of  the 
fyftem,  as  of  the  rectum  mteftinum,  the  urethra,  the  gula  or 
throat ;  and  of  thus  kind  is  the  veruca  or  wart,  and  the  clavus  pe- 
dum,  or  corns  on  the  toes.  A  wen  fometimes  arifes  on  the  back 
ef  .the  neck,  awd  fometimes  between  the  moulders ;  and  by  dif- 
tending  the  tendinous  fafcia  produces  great  and  perpetual  pain. 

M.  M.  Mercurial  ointment.  Cover  the  part  with  oiied  filk. 
Extirpation.  Electric  ihocks  through  the  tumour.  An  iiiue 
into,  the  fubftance  of  the  wen.  Opium.  Ether  externally. 

23.  Scirrbus  re'fti   inteftini.     Scirrhus    of  the  rectum.      A 
fcirrhus  frequently    affects  a  canal,  and  by  contracting  its  diam- 
eter becomes  a  painful  and  deplorable  difeafe.     The  canals  thus 
obltructed  are  the  rectum,-  the  urethra,  the  throat,  the  gall-;ciucts, 
and  probably  the  excretory  ducts  of  the  lymphatics,  and  of  oth- 
er glands. 

The  fcirrhus  of  the  rectum  is  known  by  the  patient  having 
pain  in  the  part,  and  being  only  able  to  part  with  liquid  feces, 
«nd  by  the  introduction  of  the  finger  j  the  fwelled  part  of  the 
teftine  is  fometimes  protruded  downwards,  and  hangs  like  a 
valve,  fmooth  and  hard  to  the  touch,  with  an  aperture  in  the 
centre  of  it.  See  a  paper  on  this  fubject  by  J.  Sherwin.  Me- 
moirs of  a  I^ondon  Medical  Society,  Vol.  II.  p.  9. 

M.  M.    -To  take  but  little  foiid  food.     Aperient  medicines. 

Introduce 


DISEASES          CLASS  L  2,  3.  24. 

Introduce  a  candle  fmcared  with  mercurial  ointment.  Sponge- 
tent.  Clyfters  with  forty  drops  of  laudanum.  Introduce  a. 
leathern  canula,  or  gut,  and  then  either  a  wooden  nmnidril,  or 
blow  it  up  with  air,  fo  as  to  diftend  the  contracted  part  as  much 
as  the  patient  can  bear.  Or  fpread  mercurial  platter  on  thick 
foft  leather,  and  roll  it  up  with  the  plafter  outwards  to  any  thick- 
nefs  and  length,  which  can  be  eafily  introduced  and  worn  ;  or 
two  or  three  luch  pieces  may  be  introduced  after  each  other. 
The  fame  may  be  ufed  to  comprefs  bleeding  internal  piles.  Ses 
Clais  I.  2.  i.  6.  Rub  mercurial  ointment  on  the  fphincter  ani 
every  night  for  a  fortnight. 

May  not  this  difeafe 'be  cured  by  lunar  cauftic  applied  on  the 
end  of  a  peiiary  or  bougie,  in  the  fame  mariner  as  ufed  by  J. 
Hunter,  and  fmce  by  Mr.  E.  Home,  in  Uriel:  ures  of  the  urethra; 
when,  on  introducing  the  finger,  a  kind  of  membranous  valve  can 
be  diflinguifhed  rather  than  an  extenfive  fcirrhus  or  induration. 
See  the  next  article. 

24.  Scirrhus  urethra.  Scirrhus  of  the  urethra.  The  pafTage 
becomes  contracted  by  the  thickened  membrane,  and  the  urine  is 
forced  through  with  great  difficulty,  and  is  thence  liable  to  dif- 
tend the  canal  behind  the  ftri&ure  ;  till  at  length  an  aperture  is 
made,  and  the  urine  forces  its  way  into  the  cellular  membrane, 
making  large  fmufes.  This  fituation  fometimes  continues  many 
months,  or  even  years,  and  fo  much  matter  is  evacuated  after 
making  water,  or  at  the  fame  time,  by  the  aclion  of  the  mufcles 
in  the  vicinity  of  the  finufes,  that  it  has  been  miflaken  for  an  in- 
creafed  fecretion  from  the  bladder,  and  has  been  erroneouily 
termed  a  catarrh  of  the  bladder.  See  a  paper  by  Dr.  R.  W. 
Darwin  in  the  Medical  Memoirs. 

M.  M.  Diiiend  the  part  gradually  by  catgut  bougies,  which 
by  their  compreflion  will  at  the  fame  time  diminim  the  thicknefs 
of  the  membrane,  or  by  bougies  of  elailic  gum,  or  of  horn  boil- 
ed foft.  The  patient  fhould  gain  the  habit  of  making  water 
flowly,  which  is  a  matter  of  the  utmoit  confequence,  as  it  pre- 
vents the  diftention  and  confequent  rupture,  of  that  part  of  the 
urethra,  which  is  between  the  itridture  and  the  neck  of  the  blad- 
der. 

When  there  occurs  an  external  ulcer  in  the  perinasum,  and 
the  urine  is  in  part  difcharged  that  way,  the  difeafe  cannot  be 
miftaken.  Ojherwife,  from  the  quantity  of  matter,  it  is  gener- 
ally fuppofed  to  come  from  the  bladder,  or  prod-ate  gland  ;  and 
the  urine,  which  escapes  from  the  ruptured  urethra,  mines  its 
way  amongflrthe  mufcles  and  membranes,  and  the  patient  dies 
tabid,  owing  to  the  want  of  an  external  oriiice  to  difcharge  the 
matter.  See  ClafsIL  i.  4.  u. 

Mr.  Home 


£LASS!.  2.  3.  25.         OF  IRRITATION.  rot 

Mr.  Tfime  has  publifhed  a  very  ingenious  and  ufefu*  work, en- 
titled, u  Diflertation  on  Strkl  tires  of  the  Urethra,  in  which  he  has 
recorded  many  eales  fuccefsfully  treated  by  lunar  cauftic,  initrt- 
in  tlie  end  of  a  bougie,  and  applied  to  the  contracted  part  of 
the  urethra,  fo  as  to  deilroy  the  ftridl lire. 

From  the  form  of  the  caviiy  of  the  urethra,  taken  by  injecting 
wax  into  it,  there  appears  naturally  to  exift  a  kind  of  valve  im- 
mediately behind  the  bulb  of  the  urethra,  which  when  the  penis 
is  creel,  liiuts  up  the  orifice,  and  prevents  the  reg.urgitation  of 
the  femen  into  the  bladder  during  the  action  of  the  accelerator 
mufcles  in  the  act  of  its  expjulfion  ;  and  this  natural  conflriction. 
or  valve  appears  generally  to  be  the  firil  feat  of  ftricture. 

Above  the  bulb,  about  two  or  three  inches  from  the  orifice 
of  the  glans,  the  cavity  of  the  urethra  appears  allo  lefTened  j  and 
in  fome  cafes  the  orifice  of  the  very  extremity  appears  lefs  than, 
other  parts  of  the  canal  ;  thcfe  parts  are  therefore  more  contract^ 
ed  during  the  emiilio  ferninis,  and  add  to  its  velocity  at  its  exit ; 
and  are  thence  more  liable  to  fcirrhofity  or  ilriclure.  And  by 
fome  observations,  Mr.  Home  has  (hewn,  that  a  fympathy  exifts 
between  the  ftrictures  of  thefe  parts  ;  and  that  the  more  for- 
\vard  ftrictures  are  frequently  produced  in  confequence  of  that 
behind  the  bulb  ;  and  finds  it  neceiTary  to  deftroy  them  all,  by- 
frequent  application  of  the  cauftic. 

By  the  ufe  of  which,  (which  .was  firfl  propofed  by  Wifeman, 
firft  applied  by  John  Hunter,  and  fo  greatly  improved  by  Mr. 
Home)  the  lives  of  great  numbers  are  rendered  happy,  who  oth- 
erwife  gradually  periih  by  a  mod  painful  and  hopelefs  malady. 

25.  Srirrbns  aefiphagi.  A  fcirrhus  of  the  throat  contracts  the 
pafiiige  fo  as  to  render  the  fwallowing  of  folids  impracticable,  and 
,of  liquids  difficult.  It  affects  patients  of  all  ages,  but  is  probably 
molt  frequently  produced  by  (wallowing  hard  angular  fubflan- 
when  people  have  loft  their  teeth  ;  by  which  this  membrane 
is  over-diftended,  or  torn,  or  otherwile  injured. 

M.  M.  Put  milk  into  a  bladder  tied  to  a  canula  or  catheter  ; 
introduce  it  palt  the  ftriclnre,  and  prefs  it  into  the  ftomach. 
Diftend  the  liriclure  gradually  by  a  fponge-tent  faftened  to  the 
end  of  whalebone,  or  by  a  plug  of  wax,  or  a  fpermaceti  candle, 
about  two  inches  long ;  which  might  be  introduced,  and  left 
there  with  a  Itring  only  fixed  to  it  to  hang  out  of  the  mouth,  to 
keep  it  in  its  place,  and  to  retract  it  by  occafionally  ;  for  which 
purpofc  the  firing  mull  be  put  through  a  catheter  or  hollow  pro- 
bang,  when  it  is  to  be  retracted.  Or  laftiy,  introduce  a  gut 
fixed  to  a  pipe  ;  and  then  diftend  it  by  blowing  wind  into  it. 
The  fwallowing  a  bullet  with  a  firing  put  through  it,  to  retract 
iv  on  the  exhibition  of  on  emetic,  has  alto  been  propofed.  Ex- 

tern  ally, 


DISEASES  CLASS  I.  2. 3. 2$, 

ternally,  mercurial  ointment  has  been  much  recommended. 
Poultice.  Oiled  filk.  Clyfters  of  broth.  Warm  bath  of  broth. 
Transfufion  of  blood  into  a  vein  three  or  four  ounces  a  day  ? 
SeeClafsIII.  i.  i.  15. 

I  directed  a  young  woman,  about  twenty-two   years  of  age, 
to  be  fed  with  new  milk  put  into  a  bladder,  which  was  tied  to  a 
catheter,  and  introduced  beyond  the  ftricture  in  her  throat ;  af- 
ter a  few  days,  her  fpirits  iunk,  and  (he  refufed  to  ufe  it  further, 
and  died.     Above  thirty  years  ago,  I  propofed  to  an  old  gentle- 
man, whole  throat  was  entirely  impervious,  to  fupply  him  with 
3  few  ounces  of  blood  daily  from  an  afs,  or  from  the  human  an- 
imal, who  is  ftill  more  patient  and  tractable,  in  the   following 
manner  :  To  fix  a  filver  pipe  about  an  inch  long  to  each  extrem- 
ity of  a  chicken's  gut,  the  part  between  the  two  filver  ends  to  be 
meafured  by  filling  it  witjli  warm  water  ;  to  put  one  end  into 
the  vein  of  a  perfon  hired  for  that  purpofe,  fo  as  to  receive  the 
blood  returning  from  the  extremity  ;  and  when  the  gut  was  quite 
full,  and  the  blood  running  through  the  other  iilver  end,  to  in- 
troduce that  end  into  the  vein  of  the  patient  upwards  towards 
the  heart,  fo    as  to  admit  no   air  along  with  the  blood.     And 
laftly,  to  fupport  the  gut  and  filver  ends  on  a  water-plate,  fill- 
ed with  water  of  ninety-eight  degrees  of  heat,  and  to  meafure 
how  many  ounces  of  blood  was  introduced  by  paffingthe  finger, 
fo  as  to  comprefs  the  gut,  from  the  receiving-pipe  to  the  deliv- 
ering-pipe  ;  and  thence  to  determine  how  many  gut-fulls  were 

given  from   the  healthy  perfon  to  the  patient.     Mr con- 

iidered  a  day  on  this  propofal,  and  then  another  day,  and  at 
length  anfwered,  that  "  he  now  found  himfelf  near  the  houfe  of 
death  •,  and  that,  if  he  could  return,  he  was  now  too  old  to  have 
much  enjoyment  of  life  ;  and  therefore  he  wiihed  rather  to  pro- 
ceed to  the  end  of  that  journey,  which  he  was  now  fo  near,  and 
v;hich  he  nmft  at  all  events  foon  go,  than  return  for  fo  ftiort  a 
time."  He  lived  but  a  few  days  afterwards,  and  feemed  quite 
carelefs  and  eafy  about  the  matter.  See  Suppl.  I.  14.  4. 

A  difficulty  of  fwallowing  food,  and  a  rejection  foon  after,  of 
the  whole  or  a  part  of  it,  may  be  often  owing  probably  to  a  fort 
of  valve  made  by  a  part  of  the  membrane  which  lines  the  cefoph- 
agus  ;  and  may  thus  referable  Ibictures  of  the  urethra ;  which 
hit  are  fo  frequently  cured  by  the  nice  application  of  lunar  cauf- 
tic,  as  defcribed  by  Mr.  jEverard  Home,  in  his  Treatife  on  Stric- 
tures of  the  Urethra.  Suppofe  a  thick  bougie,  made  of  linen 
fpread  with  adhefive  plafler,  and  rolled  up,  was  armed  at  the 
end  with  a  bit  of  lunar  cauflic,  with  which  the  ftriclture  of  the 
cefophagus  could  be  touched  repeatedly,  till  an  unarmed  bougie 
could  be  palled  readily  into  the  (tooiach  ?  Could  iuch  a  valve  DQ 

burft, 


GLASS  I.  2.  3.  26.        OF  IRRITATION,  103 

burft,  or  inverted,  by  pouring  a  pound  or  two  of  crude  mercury 
into  the  cefophagus  ? 

26.  LaEleontm  inirritabilitas.     Inirritability   of  the  la&eals  is 
defcribed  in  Sect.  XXVIII.  under  the  name  of  paralyfis  of  the 
lafteals  ;  but  as  the  word  paralyfis  has  generally  been  applied  to 
the  difobedience  of  the  mufcles  to  the  power   of  volition,  the 
name  is  here  changed  to  inirritability  of  the  la&eals,  as  more 
charafteriffic  of  the  difeafe. 

27.  Lymphaticorum    inirritabilitas.     The  inirritability  of  the 
cellular  and  cutaneous  lymphatics  is  defcribed  in  Seel:.  XXIX.  5. 
i.  and  in  Clafs  I.  2.  3.  10.     The  inirritability  of  the  cutaneous 
lymphatics  generally  accompanies  anaiarca,  and  is  the  caufe  o£ 
the  great  third  in  that  malady.     At  the  fame  time,  the  cellular 
lymphatics  acl:  with   greater  energy,  owing  to  the  greater  de- 
rivation of  fenforial  power  to  them,  in  confequence  of  the  lefs 
expenditure  of  it  by  the  cutaneous  ones  •,  and  hence  they  abforb 
the  fat,  and  mucus,  and  alfo  the  thinner  parts  of  the  urine* 
Whence  the  great  emaciation  of  the  bodyr  the  muddy  fediment, 
and  the  fmall  quantity  of  water  in  this  kind  of  dropfy, 


ORDO 


104  DISEASES  CLASS  I.  2. 4. 

ORDO  II. 

Decreafed  Irritation. 

GENUS  IV. 
With  deer e fifed  AEiions  of  'other  Cavities  and  Membranes. 

MANY  of  the  difeafes  of  this  genus  are  attended  with  pain, 
and  with  cold  extremities,  both  which  ceafe  on  the  exhibition 
of  wine  or  opium  5  which  (hews,  that  they  originate  from  de- 
iicient  action  of  the  altered  organ.  Thefe  pains  are  called  ner- 
vous or  fpafmodic,  are  not  attended  with  fever,  but  are  fre- 
quently fucceeded  by  convuKionsandmadnefs  ;  both  which  be- 
long to  the  clafs  of  volition.  Some  of  them  return  at  periods, 
and  when  thefe  cari  be  afcertained,  a  much  lefs  quantity  of  opi- 
um will  prevent  them,  than  is  neceflary  to  cute  them,  when  they 
are  begun  ;  as  the  vefTels  are  then  torpid  and  mirritable  from 
the  want  of  fenforial  power,  till  by  their  inaction  it  becomes 
again  accumulated. 

Our  organs  of  fenfe,  properly  fo  called,  are  not  liable  to  pain 
from  the  abfence  of  their  appropriated  ftimuli,  as  from  darknefs 
or  filence  j  but  the  other  ienfes,  which  may  be  more  properly 
called  appetites,  as  thofe  by  which  we  perceive  heat,  hunger, 
thirft,  luft,  want  of  frefh  air,  are  affected  with  pain  from  the  de- 
fect or  abfence  of  their  accuftomed  ftimuli,  as  well  as  with  pleaf- 
ure  by  the  pofTeffion  of  them  ;  it  is  probable  that  fome  of  our 
glands,  the  fenfe  or  appetite  of  which  requires  or  receives  fome- 
thing  from  the  circulating  blood,  as  the  pancreas,  liver,  teftes, 
proftate  gland,  may  be  affected  with  aching  or  pain,  when  they 
cannot  acquire  their  appropriated  fluid. 

Wherever  this  defett  of  flimulus  occurs,  a  torpor  or  inaction 
of  the  organ  enfues,  as  in  the  capillaries  of  the  fkin,  when  expo- 
fed  to  cold  ;  and  in  the  glands,  which  fecrete  the  gaftric  juice, 
when  we  are  hungry.  This  torpor  however,  and  concomitant 
pain,  which  are  at  firft  owing  to  defect  of  ftimulus,  are  after- 
wards induced  by  other  affociations  or  catenations,  and  confti- 
tute  the  beginning  of  ague-fits. 

It  muft  be  further  obferved,  that  in  the  difeafes  of  pain  with- 
out fever,  the  pain  is  frequently  not  felt  in  the  part  where  the 
caufe  of  the  difeafe  refides  ;  but  is  induced  by  fympathy  with  a 
diftant  part,  the  irritability  or  fenfibility  of  which  is  greater  or 
lefs  than  its  own.  Thus  a  ftone  at  the  neck  of  the  bladder,  if  its 
ftimulus  is  not  very  great,  only  induces  the  paiu  of  itrangury  at 

the 


CLASS  I.  2. 4.  i.         OF  IRRITATION.  loj 

the  glans  penis.  If  its  ftimulus  be  greater,  it  then  induces  pain 
at  the  neck  of  the  bladder.  The  concretions  of  bile,  which  are 
protruded  into  the  neck  of  the  gall-bladder,  when  the  difeafe  is 
not  very  great,  produce  pain  at  the  other  extremity  of  the  bile- 
duel:,  which  enters  the  duodenum  immediately  under  the  pit  of 
the  ftomach  ;  but,  when  the  difeafe  is  great -from  the  largenefs 
of  the  bile-ftone,  the  pain  is  felt  in  the  region  of  the  liver  ac  the 
neck  of  the  gall-bladder. 

It  appears  from  herrce,*  that  the  psircs  enumerated  in  this  ge- 
nus are  confequences  of  the  inactivity  of  the  organ  •,  and,  as  they 
do  not  occaiion  other  difeafes,  ihould  be  claffed  according  to 
their  proximate  caufe,  which  is,  defective  irritation  ;  there  are 
neverthelefs  other  pains  from  defect  of  ftimulus,  which  produce 
convulfions,  and  belong  to  Clafs  III.  i.  I.  ;  and  others,  which 
produce  pains  of  fome  diftant  part  by  aflbciacion,  and  belong  to 
Clafs  IV.  2.  2. 

SPECIES. 

I.  Sitif.  Thirft.  The  fenfes  of  thirft  and  of  hunger  feeni 
to  have  this  connexion,  that  the  former  is  fituated  at  the  upper 
end,  and  the  latter  at  the  lower  end  of  the  fame  canal.  One 
about  the  pharinx,  where  the  cefophagus  opens  into  the  mouth, 
and  the  other  about  the  cardia  ventriculi,  where  it  opens  into  the 
ftomach.  The  extremities  of  other  canals  have  been  (hewn  to 
poflefs  correfpondent  fenfibilities,  or  irritabilities,  as  the  two  ends 
of  the  urethra,  and  of  the  common  gall-duet.  See  IV.  2.  2.  2. 
and  4. 

The  membrane  of  the  upper  end  of  the  gullet  becomes  torpid, 
and  confequently  painful,  when  there  is  a  deficiency  of  aqueous 
3uid  in  the  general  fyftem  ;  it  then  wants  its  proper  ftimulus. 
In  the  fame  manner  a  want  of  the  ftimulus  of  more  folid  mate- 
rials at  the  other  end  of  the  canal,  which  terminates  in  the  ftom- 
ach, produces  hunger  ;  as  mentioned  in  Seet.  XIV.  8.  The 
proximate  caufes  of  both  of  them  therefore  confift  in  deficient 
irritation,  when  they  are  confidered  as  pains  •,  becaufe  thefe  pains 
are  in  confcquence  of  t-he  inactivity  of  the  organ,  according  to 
the  fifth  law  of  animal  caufation.  Seel:.  IV.  5.  But  when  they 
are  confidered  as  defires,  namely,  of  liquid  or  folid  aliment, 
their  proximate  caufe  confifts  in  the  pain  of  them,  according  to 
the  fixth  law  of  animal  caufation.  So  the  proximate  caufe  of 
the  pain  of  coldnefs  is  the  inactivity  of  the  organ,  and  perhaps 
the  confequent  accumulation  of  fenforial  power  in  it ;  but  the 
pain  itfelf  or  the  confequent  volition,  is  the  proximate  caufe  of  the 

VOL.  II.  P  (huddering 


io6  DISEASES  CLASS  I.  2. 4.  2, 

fhuddering  and  gnafhing  the  teeth  in  cold  fits  of  intermittent  fe- 
vers.    See  Clafs  I.  2.  2.  i. 

Thirft  may  be  divided  into  two  varieties,  alluding  to  the  re- 
mote caufe  of  each,  and  may  be  termed  fitis  calida,  or  warm 
thirft,  and  fitis  frigida,  or  cold  thirft.  The  remote  caufe  of  the 
former  arifes  from  the  diflipation  of  the  aqueous  parto  of  our 
fluids  by  the  increafed  fecretion  of  perfpirable  matter,  or  other 
evacuations.  And  hence  it  occurs  in  hot  fits  of  fever,  and  after 
taking  much  wine,  opium,  fpice,  fait,  or  other  drugs  of  the  Art. 
incitantia  or  fecernentia.  The  thirft,  which  occurs  about  three 
hours  after  eating  a  couple  of  red  herrings,  to  a  perfon  unaccui- 
tomed  to  falted  meat,  is  of  this  kind  ;  the  increafed  action  of  the 
cutaneous  veflels  diilipates  fo  much  of  our  fluids  by  infenfible 
perfpiration,  as  to  require  above  two  quarts  of  water  to  reftore 
the  fluidity  of  the  blood,  and  to  waih  the  fait  out  of  the  fyftem. 
See  Art.  III.  2.  i. 

M.  M.  Cold  water.     Vegetable  acids.     Warm  bath. 

The  remote  caufe  of  fitis  frigida,  or  cold  thirft,  is  owing  t& 
the  inaction  of  the  cutaneous,  pulmonary,  urinary,  and  cellular 
abforbents  ;  whence  the  blood  is  deprived  of  the  great  fupply  of 
moifture  which  it  ought  to  receive  from  the  atmofphere,  and 
from  the  cells  of  the  cellular  membrane,  and  from  other  cyfts ; 
this  caufe  of  thirft  exifts  in  dropfies,  and  in  the  cold  fits  of  inter- 
mittents.  The  defire  of  fluids,  like  that  of  folids,  is  liable  to  ac- 
quire periods,  and  may  therefore  readily  become  difeafed  by  in- 
dulgence in  liquids  grateful  to  the  palate. 

Of  difeaied  thirft,  the  moft  common  is  either  owing  to  defect 
of  the  aft  ion  of  the  numerous  abforbent  veifels  on  the  neck  of 
the  bladder,  in  which  the  patient  makes  much  paleiih  water  ;  or 
to  the  defeclive  abforption  of  the  fkin  and  lungs,  in  which  the 
patient  makes  but  little  water,  and  that  high-coloured,  and  with 
fediment.  In  both  the  tongue  and  lips  are  liable  to  become  very 
dry.  The  former  in  its  greateft  degree  attends  diabetes>  and  the 
latter  anafarca. 

M.  M.  Warm  water,  warm  wine,  warm  bath.  Opium. 
Cold  bath.  Iced  water.  Lemonade.  Cyder. 

2.  Efuries.  Hunger  has  been  fancifully  afcribed  to  the  fides 
of  the  ftomach  rubbing  againft  each  other,  and  to  the  increafed 
acidity  of  the  gaftric  juice  corroding  the  coats  of  it.  If  either 
of  thefe  were  the  caufe  of  hunger,  inflammation  muft  occur,  when 
they  had  continued  fome  time  •,  but,  on  the  contrary,  coldnefs 
not  heat  is  attendant  on  hunger;  which  evinces,  that  like  third 
it  is  owing  to  the  inactivity  of  the  membrane,  which  is  the  feat 
of  it ;  while  the  abundant  nerves  about  the  cardia  ventriculi, 

and 


CLASS  I.  2.  4.  3.       OF  IRRITATION,  107 

and  the  pain  of  hunger  being  felt  in  that  part,  gives  great  reafon 
to  conclude,  that  it  is  there  iituated. 

The  fenfe  of  hunger  as  well  as  of  thirft,  is  liable  to  acquire 
habits  in  refpect  to  the  times  of  its  returning  painfulnefs,  as  well 
as  in  refpect  to  the  quantity  required  to  fatiate  its  appetency, 
and  hence  may  become  difeafed  by  indulgence,  as  well  as  by 
want  of  its  appropriate  flimulus.  Thofe  who  have  been  accuf- 
tomed  to  diftend  their  ftomach  by  large  quantities  of  animal  and 
vegetable  food,  and  much  potation,  find  a  want  of  diftenticn, 
when  the  ftomach  is  empty,  which  occafions  faintnefs,  and  is 
miltaken  for  hunger,  but  which  does  not  appear  to  be  the  fame 
fenfation.  I  was  well  informed,  that  a  woman  near  Litchfield, 
who  eat  much  animal  and  vegetable  food  fora  wager,  affirmed, 
that  fince  diftending  her  ftomach  fo  much,  (he  had  never  felt 
herfelf  fatisfied  with  food  ;  and  had  in  general  taken  twice  as 
much  at  a  meal,  as  (he  had  been  accuftomed  to,  before  (he  eat 
fo  much  for  a  wager. 

3.  Naufeajicca.      Dry  naufea.     Confifts  in   a  quiefcence   or 
torpor  of  the  mucous  or  falivary  glands,  and  precedes  their   in- 
verted motions,   defcribed  in  naufea  humida,   Clafs   I.  3.  2.   3. 
In  the  fame  manner  as  ficknefs   of  the  ftomach   is   a  quiefcence 
of  that  organ  preceding  the  action  of  vomiting,  as  explained  in 
Sect.  XXXV.  i.  3.     This  is  fometimes  induced  by  difagreeable 
drugs  held  in  the  mouth,  at  other  times  by  difguftful  ideas,  and 
at  other  times  by  the  affociation  of  thefe  actions  with  thofe   of 
the  ftomach  ;  and    thus  according  to    its   different    proximate 
caufes  may  belong  to  this,  or  to  the  fecond,  or  to   the  fourth 
clafs  of  difeafes. 

M.  M.  Lemonade.     Tafteful  food.     A  blifter.    Warm  bath. 

4.  JEgritudo  ventriciili.     Sicknefs  of   ftomach  is  produced  by 
the  quiefcence  or    inactivity  of  that   organ,  as    is  explained   in 
Sect.  XXXV.  i.   3.     It  confifts  in  the  (late  between  the  ufual 
periftaltic  motions  of  that  organ,  in  the  digeftion  of  our  aliment 
and  the  retrograde  motions  of  it  in  vomiting  ;  for  it  is  evident, 
that  the  direct  motions  of  it  from  the  cardia  to  the  pylorus  muft 
flop,  before  thofe  in  a  contrary  direction  can  commence.     This 
ficknefs,  like  the  naufea  above  defcribed,  is  fometimes  produced 
by  difguftful  ideas,  as  when   nafty  objects  are  feen,  and  nafty 
(lories  related,  as  well  as  by  the  exhauftionof  the  fenforial  pow- 
er by  the  ftimulus  of  fome  emetic  drugs,   and  by  the   defect  of 
the  produdtion  of  it,  as  in  enfeebled  drunkards. 

Sicknefs  may  likewife  confift  in  the  retrograde  motions  of  the 
lymphatics  of  the  ftomach,  which  regurgitate  into  it  the  chyle  or 
lymph,  which  they  have  lately  abforbed,  as  in  Clafs  I.  3.  2.  3.  It 
is  probable,  that  thefe  two  kinds  of  ficknefs  may  be  different  fen- 

fations* 


io8  -DISEASES  GLASS  I.  2. 4.  $. 

iations,  though  they  have  acquired  but  one  name ;  as  one  of  them 
attends  hunger,  and  the  other  repletion  ;  though  either  of  them, 
jmay  poffibiy  be  induced  by  affbciation  with  naufeous  ideas. 

M.  M.  A  blifier  on  the  back.  An  emetic.  Opium.  Crude 
rnercury.  Covering  the  head  in  bed.  See  Sect.  XXV.  16.  Clafs 
IV.  i.  i.  2.  and  3. 

5.  Cardialgla.  Heartburn  originates  from  the  inactivity  of 
the  flomach,  whence  the  aliment,  inftead  of  being  fubdued  by 
digeftion,  and  converted  into  chyle,  runs  into  fermentation,  pro- 
ducing acetous  acid.  Sometimes  the  gaftric  juice  itielf  becomes 
fo  acid  as  to  give  pain  to  the  upper  orifice  of  the  ftomach  ;  thefe 
acid  contents  of  the  ftomach,  on  falling  on  a  marble  hearth, 
have  been  feen  to  produce  an  efferyefcence  on  it.  The  pain  of 
heat  at  the  upper  end  of  the  gullet,  when  any  air  is  brought  up 
from  the  fermenting  contents  of  the  ftomach,  is  to  be  afcribed 
to  the  fympathy  between  thefe  two  extremities  of  the  cefophagus 
rather  than  to  the  pungency  of  the  carbonic  gas,  or  fixed  air  j 
as  the  fenfation  in  fwal lowing  that  kind  of  air  in  water  is  of  a 
different  kind.  See  Clafs  I.  3.  JL.  3.  and  IV.  2.  2.  5. 

M.  M.  This  difeafe  arifing  from  indigeftion  is  often  very  per- 
tinacious, and  afflicting  ;  and  attended  with  emaciation  of  the 
body  from  want  of  fufficient  chyle.  As  the  faliva  fwallowed 
along  with  our  food  prevents  its  fermentation,  as  appears  by  the 
experiments  of  Pringle  and  Macbride,  fome  find  considerable  re- 
lief by  chewing  parched  wheat,  or  maftic,  or  a  lock  of  wool,  fre- 
quently in  a  day,  when  the  pain  occurs,  and  by  fwallowing  the 
faliva  thus  efFufed  ;  a  temporary  relief  is  often  obtained  from  an- 
tiacids,or  aerated  alkaline  water,  Seltzer  water,  calcareous  earths, 
alkaline  falts  made  into  pills  with  foap,  foap  alone,  tin,  milk, 
bitters.  More  permanent  ufe  may  be  had  from  fuch  drugs  as 
check  fermentation,  as  acid  of  vitriol  ;  but  ftill  more  permanent 
relief  from  fuch  things  as  invigorate  the  digeftion,  as  a  blifter  on 
the  back  ;  a  due  quantity  of  vinous  fpirit  and  water  taken 
regularly.  Steel.  Temperance.  A  fleep  after  dinner.  A  waift- 
coat  made  fo  tight  as  ilightly  to  comprefs  the  bowels  and  ftom- 
ach. A  flannel  fliirt  in  winter,  not  in  fummer.  A  lefs  quan- 
tity of  potation  of  all  kinds.  Ten  black  pepper-corns  fwallow- 
ed after  dinner.  Half  a  grain  of  opium  twice  a  day,  or  a  grain. 
The  food  fhould  confift  of  fuch  things  as  do  not  eafily  ferment, 
as  flefti,  fhell-fifli,  fea-bifcuit,  toafted  cheefe.  I  have  feen  toaft- 
ed  cheefe  brought  up  from  the  ftomach  24  hour^  after  it  had 
been  fwallowed,  without  apparently  having  undergone  any- 
chemical  change.  See  Clafs  II.  i.  3.  17.  and  IV.  i.  2.  13. 

It  is  probable  that  violent  cardialgia  is  moil  frequently  owing 
to  increafe  of  the  quantity  or  acidity  of  the  gaftric  juice,  rather 

than 


*s  I.  2.  4. 6.          OF  IRRITATION.  109 

than  to  the  acetous  acid  produced  by  fermenting  aliment ;  be- 
caufe  in  violent  afepfy,  as  in  low  fevers,  and  total  want  of  di- 
geftion,  no  fuch  violently  ftrong  or  painful  acidity  occurs.  Sec 
I.  3.  i.  3.  See  Anorexia  II.  2.  2.  i.  And  fecondly,  becaufe 
in  all  thefe  cafes,  which  have  come  under  my  eye,  the  difeafc 
was  not  increafed  by  vegetable  food,  or  even  by  acid  fruits,  when 
taken  in  their  ufual  quantity;  and  I  have  uniformly  oblerved, 
that  the  food  which  fuited  the  palate,  and  that  water  alone,  or 
fmall  wine  and  water,  agreed  with  thefe  patients  better  than 
ilronger  mixtures  of  fpirit  and  .water,  efpecially  when  they  v/erc 
more  agreeable  to  the  palate. 

6.  Arthritis  Veninciili.     Sicknefs   of   the  -ftomach  in  gouty 
cafes  is  frequently  a  confequence  of  the  torpor  or  inflammation 
of  the  liver,  and  then  it  continues  many  days  or  weeks.     But 
when  the  patient  is  feized  with  great  pain  at  the  ftomach  with 
the  fenfation  of  coldnefs,  which  they  have  called  an  ice-bolt,  this 
Is  a  primary  affection  of  the  ftomach,  and  deftroys  the  patient 
m  a  few  hours,  owing  to  the  torpor  or  inaction  of  that  vifcus  fo 
important  to  life. 

This  primary  gout  of  the  ftomach,  as  it  is  a  torpor  of  that 
vifcus,  is  attended  with  fenfation  of  coldnefs,  and  with  real  de- 
fect of  >heat  in  that  part,  and  may  thence  be  diftinguimed  from 
the  pain  occafioned  by  the  paiTage  of  a  gall-ftone  into  the  duod- 
enum, as  well  as  by  the  weak  pulfe,  and  cold  extremities  ;  to 
which  muft  be  added,  that  it  affects  thofe  only,  who  have  been 
long  afflicted  with  the  gout,  and  much  debilitated  by  its  numer- 
ous attacks. 

M.  M.  Opium.  Vinous  fpirit.  Volatile  alkali.  Spice. 
Warmth  applied  externally  to  the  ftomach  by  hot  cloths  or  fo- 
mentation. 

7.  Golica  fatulenta.     The  flatulent  colic  arifes  from  the  too 
great  diftention  of  the  bowel  by  air,  and  confequent  pain.     The 
caufe  of  this  difeafe  is  the  inactivity  or  want  of  fuiEciently  pow- 
erful contraction  of  the  coats  of  the  bowel,  to  carry  forwards  the 
gas  given  up  by  the  fermenting  aliment.     It  is  without  fever, 
and  generally  attended  with  cold  extremities. 

It  is  diftinguifhed,  firft,  from  the  pain  occafioned  by  the  paf- 
fage  of  a  gall-ftone,  as  that  is  felt  at  the  pit  of  the  ftomach,  and 
this  nearer  the  navel.  Secondly,  it  is  diftinguifhed  from  the 
colica  faturnina,  or  colic  from  lead,  as  that  arifmg  from  the  tor- 
por of  the  liver,  or  of  fome  other  vifcus,  is  attended  with  greater 
coldnefs,  and  with  an  aching  pain  ;  whereas  the  flatulent  colic 
being  owing  to  diftention  of  the  mufcles  of  the  bowel,  the  pain 
is  more  acute,  and  the  coldnefs  lefs.  Thirdly,  it  is  diftinguifli- 
<ul  from  inflammation  of  the  bowels,  or  ileus,  as  perpetual  vomr 

king 


DISEASES  CLASS  I.  2. 4.  8. 

itingand  fever  attend  this.  Fourthly,  it  is  diftinguifhed  from 
cholera,  becaufe  that  is  accompanied  with  both  vomiting  and  di- 
arrhoea. And  laftly,  from  the  colica  epileptica,  or  hyfteric  col- 
ic, as  that  is  liable  to  alternate  with  convulfion,  and  fometimes 
with  infanity  ;  and  returns  by  periods. 

M.  M.  Spirit  of  wine  and  warm  water,  one  fpoonful  of  each. 
Opium  one  grain.  Spice.  Volatile  alkali.  Warm  fomenta- 
tion externally-  Rhubarb. 

8.  Colica  faturmna.  Colic  from  lead.  The  pain  is  felt  about 
the  navel,  is  rather  of  an  aching  than  acute  kind  at  firft,  which 
increases  after  meals,  and  gradually  becomes  more  permanent 
and  more  acute.  It  terminates  in  paralyfis,  frequently  of  the 
mufcles  of  the  arm,  fo  that  the  hand  hangs  down,  when  the 
arm  is  extended  horizontally.  It  is  not  attended  with  fever,  or 
increafe  of  heat.  The  feat  of  the  difeafe  is  not  well  afcertain- 
ed  ;  it  probably  affects  fome  part  of  the  liver,  as  a  pale  bluifh 
countenance  and  deficiency  of  bile  fometimes  attend  or  fucceed 
it,  with  confequent  anafarca  ;  but  it  feems  to  be  caufed  imme- 
diately by  a  torpor  of  the  interline,  whether  this  be  a  primary  or 
fecondary  affection,  as  appears  from  the  conftipation  of  the 
bowels,  which  attends  it  ;  and  is  always  produced  in  confe- 
quence  of  the  great  (limulus  of  lead  previoully  ufed  either  inter- 
nally for  a  length  of  time,  or  externally  on  a  large  furface. 

A  delicate  young  girl,  daughter  of  a  dairy  farmer,  who  kept 
his  milk  in  leaden  cifterns,  ufed  to  wipe  off  the  cream  from  the 
edges  of  the  lead  with  her  finger  ;  and  frequently,  as  fhe  was 
fond  of  cream,  licked  it  from  her  finger.  She  was  feized  with 
the  faturnine  colic,  and  femi-paralytic  wrifts,  and  funk  from 
general  debility. 

A  feeble  woman  about  forty  years  of  age,fprained  her  ancle, 
and  bruifed  her  leg  and  thigh  ;  and  applied  by  ill  advice  a  folu- 
tion  of  lead  over  the  whole  limb,  as  a  fomentation  and  poultice 
for  about  a  fortnight.  She  was  then  feized  with  the  colica  fa- 
turnina,  loll  the  ufe  of  her  wrifts,  and  gradually  funk  under  a 
general  debility. 

There  are  various  means  by  which  lead  finds  its  way  into  the 
fyftem  ;  in  the  cyder  counties  of  this  country  this  difeafe  has 
been  frequently  almoft  epidemic  from  the  ufe  of  fome  lead  about 
their  mills,  or  by  the  pernicious  uie  of  it  to  correct  the  acidity 
of  weak  cyder.  This  difeafe  has  been  fo  frequent  in  fome  of  the 
wine  countries,  that  in  France  the  punifhment  of  death  is  di- 
rected for  thofe,  who  ufe  lead  to  deflroy  the  acidity  of  wine. 

There  is  a  bad  cuftomin  almoft  all  families  and  public  houfes 
of  warning  out  their  bottles  by  putting  a  handful  of  (hot  corns 
into  them,  and  by  fhaking  them  about  forcibly,  by  which  the 

lead 


CLASS  I.  2.  4.  8.  OF  IRRITATION.  1 1 1 

had  may  in  part  adhere  to  the  fides  of  the  bottle,  and  become 
difiblved  >n  the  acid  of  the  wine  or  cyder.  Milk  kept  in  lead  is 
highly  pernicious,  as  in  the  in  fiance  above  related.  Nor  {hould 
coppers  for  brewing  be  edged  at  the  top  of  them  with  lead,  which 
is  frequently  done  ;  nor  fhould  fleth-meat  be  falted  in  leaden 
citterns.  Another  way  by  which  lead  is  liable  to  be  taken  into 
the  ftomach  is  by  broth,  which  is  boiled  in  copper  veil  el* 
tinne;l  within.  Now  the  lining  of  thefe  vefTels  confifts,  I  am 
•well  informed,  of  nearly  half  lead  mixed  with  the  tin  j  which  is 
very  foluble  in  hot  greafe.  From  this  caufe  thofe,  who  live 
much  on  foupb  long  boiled,  as  the  French,  ars  perpetually  fub- 
jecl  to  complaints  of  the  ilomach  and  intettines.  When  a 
fauce-pan  has  been  new  tinned,  if  the  ringer  be  rubbed  hard  on 
it,  it  becomes  black  5  which  is  owing  to  the  lead,  which  is  mix- 
ed with  the  tin.  Hence  the  broth  for  all  lick  people  fhould  be 
boiled  but  a  fhort  time,  and  be  immediately  put  into  a  china- 
bafon. 

In  an  ingenious  pamphlet  lately  publifhed  by  Mr.  Clutterbuck, 
feveral  cafes  are  given  of  the  fuccefsfui  ufe  of  mercury  in  tha 
conftipation,  colic,  and  paralyfis  of  the  wrifts,  produced  by  lead* 
In  fome  of  thefe  patients  a  drachm  of  ilrong  mercurial  ointment 
was  rubbed  morning  arid  night  on  the  wrifts,  till  the  mouth  be- 
came fore.  In  others  calomel  one  grain  was  given  daily  with  ol. 
ricini  ;  and  mothers  a  quarter  of  a  grain  ofhydragyrum  muria- 
tum,  fublimate  of  mercury,  was  given  three  times  a  day  with 
great  apparent  advantage.  The  author  ingeniouily  aflcs,  if 
imall  doles  of  fome  preparation  of  lead  might  not  be  given  inter- 
nally to  counteract:  the  ill  effects  fometimes  believed  to  refult 
from  the  too  long  ufe  of  mercury.  On  the  Poiibn  of  Lead, 
Boofey,  Lond.  See  Clafs  III.  2.  i.  4. 

The  effecl:  of  metals  in  deftroying  or  preventing  the  acidity 
of  wine  or  cyder,  may  be  nicely  obferved  in  attending  to  the 
colour  of  fyrup  of  violets  ;  which,  if  it  ferments,  is  changed  by 
the  acid  thus  produced  from  blue  to  red  :  but  if  it  be  kept  in  a 
tin  veffel,  this  does  not  occur  ;  as  the  acid  is  attracted  by  the 
metal  producing  an  oxyde.  Other  metals  are  laid  by  M.  Guy- 
ton,  to  have  the  fame  effedl  in  preferving  the  colour  of  fyrup 
of  violets. 

M.  M.  Firft  opium  one  or  two  grains,  then  a  cathartic  of 
fenna,  jalap,  and  oil,  as  foon  as  the  pain  is  relieved.  Oleum 
ricini.  ^  Alum.  Oil  of  almonds.  A  bliiler  on  the  navel.  Warm 
bath.  The  ftimulus  of  the  opium,  by  reftoring  to  the  bowel  its 
natural  irritability  in  this  cafe  of  painful  torpor,  ailiils  the  aclion 
of  the  cathartic.  A  clylter  of  the  fmoke  of  tobacco  puttied  high 

up 


DISEASES  CLASS  1. 2. 4* 9. 

up  and  continued,  or  repeated  frequently  for  ah  hour  or  two,  or 
longer,  is  faid  to  remove  the  pain,  and  totally  to  cure  the  difeafe. 

9.  Tympanitis.     Tympany  confifts  in  an  elaftic   tumor  of  the 
abdomen,  which  founds  on  being  ftruck.     It  is  generally  attend- 
ed with  coftivenefs  and  emaciation.     In  one  kind  the  air  is  faid 
to  exift   in  the  bowels,  in   which  cafe  the  tumor   is  lefs  equal, 
and  becomes  lefs  tenfe  and  painful  on  the  evacuation  of  air.    In 
the  other  kind  the  air  exifts  in  the  cavity  of  the  abdomen,  and 
fometimes  is  in  a  few  days  exchanged  for  water,  and  the  tympa- 
ny  becomes  an  afcites. 

Air  may  be  diftinguifhed  in  the  ftomach  of  many  people  by 
the  found  on  ftriking  it  with  the  ringers,  and  comparing  the 
found  with  that  of  a  fimilar  percuffion  on  other  parts  of  the 
bowels  :  but  towards  the  end  of  fevers  and  efpecially  in  the 
puerperal  fever,  a  diftention  of  the  abdomen  by  air  is  generally 
a  fatal  fymptom,  though  the  eafe,  and  often  cheerfulnefs  of  the 
patient,  vainly  flatters  the  attendants. 

M.  M.  In  the  former  cafe  a  clyfter-pipe  unarmed  may  be  in- 
troduced, and  left  fome  time  in  the  reftum,  to  take  off  the  re- 
fiftance  of  the  fphincter,  and  thus  difcharge  the  air,  as  it  is  pro- 
duced from  the  fermenting  or  putrefying  aliment.  For  this 
purpofe,  in  a  difeafe  fomewhat  fimilar  in  horfes,  a  perforation  is 
made  into  the  rectum  on  one  fide  of  the  fphincter  •,  through 
which  fiftula  the  air,  which  is  produced  in  fuch  great  excefs 
from  the  quantity  of  vegetable  food  which  they  take,  when  their 
digeftions  are  impaired,  is  perpetually  evacuated.  In  both  cafes 
alfo,  balfams,  effential  oil,  fpice,  bandage  on  the  abdomen,  and, 
to  prevent  the  fermentation  of  the  aliment,  acid  of  vitriol,  faliva. 
See  Clafs  I.  2.  4.  5. 

10.  Hypochondriacs.     The  hypochondriac  difeafe  confifts  in 
indigeftion  and  confequent  flatulency,  with  anxiety  or  want  of 
pleaiurable  fenfation.     When  the  action  of  the  ftomach  and 
bowels  is  impaired,  much  gas  becomes  generated  by  the  ferment- 
ing or  putrefcent  aliment,  and  to  this  indigeftion  is  catenated 
languor,  coldnefs  of  the  ikin,  and  fear.     For  when  the  extremi- 
ties are  cold  for  too  long  a  time  in  fome  weak  conftitutions,  indi- 
geftion is  produced  by  direct  fympathy  of  the  fkin  and  the  ftom- 
ach, with  confequent  heartburn,  and  flatulency.     The  fame  oc- 
curs, if  the  Ikin  be  made  cold  by  fear,  as  in  riding  over  dan- 
gerous roads  in  winter,  and  hence  converfely  fear  is  produced 
by  indigeftion  or  torpor  of  the  ftomach  by  affociation. 

This  difeafe  is  confounded  with  the  fear  of  death,  which  is 
an  infamty,  and  therefore  of  a  totally  different  nature.  It  is  al- 
fo  confounded  with  the  hyfteric  difeafe,  which  confifts  in  the 

retrograde 


•  ss  I.  2.  4.  1 1.       OF  IRRITATION.  113 

••£rade  motions  of  the  alimentary  canal,  and  of  fome  parts  of 
the  abforbent  fyiteivi. 

liypochondriafis,  like  chlorofis,  is  fometimes  attended 
with  very  quick  pulfe  j  which  the  patient  feems  to  bear  fo  eaii- 
ly  in  theie  two  maladies,  that  if  any  accidental  cough  attends 
them,  they  may  be  miitaken  for  pulmonary  confumption ;  which 
is  not  owing  primarily  to  the  debility  of  the  heart,  but  to  ics  di- 
rect fympathy  with  the  actions  of  the  ilomach. 

M.  M.  Blifter.  A  philer  of  Burgundy  pitch  on  the  abdo- 
men. Opium  a  grain  twice  a  day.  .Rhubarb  fix  grains  every 
night.  Bark.  Steel.  Spice.  Bath-water.  Siefta,  or  fleep 
after  dinner.  Uniform  hours  of  meals.  No  liquor  (tronger 
than  fmall  beer,  or  wine  and  water.  Gentle  exercife  on  horfe- 
back  in  the  open  air  uniformly  perfifted  in.  See  Cardialgia,  I. 

2.  4-  5- 

ii.  Cephaltta  idiopathica.  Head-achs,  which  are  attended 
with  inflammation,  are  termed  phrenitis,  defcribed  in  Clafs  II. 
i.  2.  3.  Thofe,  which  are  not  attended  with  inflammation, 
may  be  divided  into  fuch  as  affect  the  whole  head,  to  which  the 
word  cephalsea  is  applied,  and  into  fuch  as  affect  one  fide  of  the 
head  only  at  a  time,  which  is  termed  hemkrania.  The  former 
of  thefe  may  be  divided  into  cephalaea  idiopathica,  and  cephalxa 
fympathetica ;  and  the  latter  into  hemkrania  idiopathica,  and 
hemkrania  fympathetica.  Befides  thefe  there  exifts  a  cephalsea 
fomniofa,  a  eephafaea  fyphilitica,  and  a  cephalxa  hydropica. 

The  idiopathic  head-ach  frequently  attends  the  cold  paroxyfm 
of  intermittents  j  afflicts  inebriates  the  day  after  intoxication  ; 
and  many  people  who  remain  too  long  in  the  cold  bath.  In  all 
which  cafes  there  is  a  general  inaction  of  the  whole  fyftem,  and 
as  thefe  membranes  about  the  head  have  been  more  expofed  to 
the  variations  of  heat  and  cold  of  the  atmofphere,  they  are  more 
liable  to  become  affected  fo  far  as  to  produce  fenfation,  than 
cr  membranes ;  which  are  ufually  covered  either  with  clothes, 
or  with  mufcles,  as  mentioned  in  Sect.  XXXIII.  2.  10. 

The  promptitude  of  the  membranes  about  the  fcalp  to  fym- 
pathize  with  thofe  of  other  parts  of  the  fyftem  is  fo  great,  that 
this  cephalaea  without  fever,  or  quicknefs  of  pulfe,  is  more  fre- 
quently a  fecondary  than  a  primary  difeafe,  and  then  belongs  to 
Clafs  IV.  2.  2.  7.  The  hemkrania,  or  partial  head-ach,  I  be- 
li-eve  to  be  almoft  always  a  difeafe  from  aJTojciation ;  though  it 
is  not  impoffible,  but  a  perfon  may  take  cold  on  one  fide  of  the 
Lead  only.  As  fome  people  by  fitting  always  on  the  fame  fide 
of  the  fire  in  winter  are  liable  to  render  one  fide  more  tender 
than  the  other,  and  in  confequence  more  fubject  to  pains,  which 
have  been  erroneoufly  termed  rheumatic. 

VOL.  II,  M.  M.  The 


1 14  DISEASES  CLASS  L  2.  4.  i  *  < 

M.  M.  The  method  of  cure  confifls  in  rendering  the  habit 
more  robuft,  by  gentle  conftant  exercife  in  the  open  air,  fleth 
diet,  fmall  beer  at  meals  with  one  glafs  of  wine,  regular  hours 
of  reft  arid  rifing,  and  of  meals.  The  clothing  about  the  head 
fhould  be  warmer  during  fleep  than  in  the  day ;  becaufe  at  that 
time  people  are  more  liable  to  take  cold  ;  that  is,  the  membra- 
nous parts  of  it  are  more  liable  to  become  torpid  ;  as  explained 
in  SecL  XVIII.  15.  In  refpecl  to  medicine,  two  drams  of  va- 
lerian root  in  powder  three  or  four  times  a  day  are  recommend- 
ed by  Fordyce.  The  bark.  Steel  in  moderate  quantities.  An 
emetic.  A  blifter.  Opium,  half  a  grain  twice  a  day.  Decay- 
ed teeth  mould  be  extracted,  particularly  fuch  as  either  ache  or 
are  ufelefs.  Cold  bath  between  60  and  70  degrees  of  heat. 
Warm  bath  of  94  or  98  degrees  every  day  for  half  an  hour  du- 
ring a  month.  See  Clafs  IV.  2.  2.  7.  and  8.  and  IV.  2.  4.  3. 
A  folution  of  arfenic,  about  the  fixteenth  part  of  a  grain,  is  re- 
ported to  have  great  effecT:  in  this  difeafe.  It  mould  be  taken 
thrice  a  day,  if  it  produces  no  griping  or  ficknefs,  for  two  or 
three  weeks.  A  medicine  of  this  kind  is  fold  under  the  name 
of  taftelefs  ague-drops  ;  but  a  more  certain  method  of  afcer- 
taining  the  quantity  is  delivered  in  the  preceding  Materia  Med- 
ica,  Art.  IV.  2.  6.  8.  Five  grains  of  the  powdered  leaves  of 
Atropa  Belladonna  are  recommended  in  fome  foreign  publica- 
tion to  be  repeated  once  in  two  days,  and  are  faid  to  be  fuccefs- 
ful  in  the  dolor  faciei,  or  hemicrania  idiopathica. 

Cephal<ea  fomniofa.  Head-ach  from  fleep.  This  difeafe  has 
not  been  defcribed,Ibelieve,by  any  writer,  though  it  affects  fome 
invalids  for  years.  After  fome  hours  of  fleep  the  patients  are 
afflicted  with  diftreffing  dreams,  and  awake  with  pain  of  the. 
head,  which  continues  for  fome  time  after  they  awake ;  and  fo 
circumflanced  furnifhes  the  diagnoftic  fymptom  of  this  fpecies  of 
cephalaea. 

The  paroxyfms  or  repetitions  of  many  drfeafes  are  lbl>le  ta 
commence  in  fleep,  fome  from  the  increafe  of  fenfibility  during- 
ileep,  as  explained  in  Seel:.  XVIII.  5.  and  1 5 .  of  the  firfi  part  of 
this  work,  as  thofe  of  fome  epilepfies,  of  fome  afthmas,  and  of 
the  gout.  Other  difeafes  are  liable  to  return  during  fleep  from 
the  debility  of  the  pulmonary  circulation,  or  of  pulmonary  ab- 
forption,  as  in  fomnus  interruptus,  Clafs  I.  2.  I.  3.  and  in  in- 
cubus, or  night-mare,.  Clafs  III.  2.  I.  13.  and  in  haemoptoe 
venofa,  Clafs  I.  2.  i.  9.  and  probably  in  the- humoral  afthmaj 
Clafs  II.  I.  ,1,8. 

The  cephalaea  fomniofa  I  fufpedl:  to  bear  the  fame  analogy  to 
the  hydrocephalus  iuternus,  as  I  believe  the  'afthma  humorale  to 
.bear  to  the  anafarca  pulmonum  5  and  to  confrft  in  this  circum- 

ftances 


:       ,-  OF  IRRITATION.  115 

re,  tint  during  fleep  in  the  cephalxa  fomniofa  a  temporary 
•congeftion  of  fluid  may  occur  in  fome  part  of  the  brain,  as  a 
permanent  one  occurs  in  the  hydrocephalus  internus  •,  in  the 
feme  manner  as  I  believe  in  the  afthma  humorale  a  temporary 
congeflion  of  fluid  occurs  in  fome  part  within  the  cheft,  and  a 
permanent  one  in  the  anafarca  of  the  lungs. 

M.  M.  The  patient  mould  fleep  with  his  head  raifed  high 
•en  many  pillows,  and  wear  drawers  to  prevent  his  flipping  down 
in  bed.  2.  He  fhould  fleep  on  a  hardifh  bed,  or  mattrefs,  to 
prevent  his  fleeping  too  profoundly,  cr  too  long  together.  3. 
Or  he  may  be  wakened,  after  having  flept  a  certain  number  of 
hours  by  an  alarum  clock.  4.  Any  carious  teeth  mould  be  ex- 
traded,  as  the  matter  from  putrid  bones,  fwallowed  with  the 
faliva,  weakens  the  fyftem  by  its  effect  on  the  ftomach.  5. 
Twenty  drops  of  faturated  tincture  of  digitalis  may  be  taken 
twice  or  thrice  a  day  for  three  or  four  weeks.  6.  Half  a  grain 
of  opium  and  fix  grains  of  rhubarb  fhould  be  taken  every  night 
for  many  weeks  or  months.  7.  Oxygen  gas  may  be  refpired 
daily  for  a  time,  till  its£fFec"i  can  be  known. 

12.  Hemifrania  idiopatbica.  This  difeafeis  defcribed  by  Sau- 
vage,  under  the  name  of  trifmus  dolorificus,  or  tic  douloureux,  in 
Clafs  IV.  ord.  i.  gen.  2.  fpec.  14.  of  his  elaborate  work.  But 
the  word  trifmus  is  an  improper  name,  as  no  fixed  fpafm  like  the 
locked  jaw  exifts  in  this  malady,  nor  any  flridor  dentium,  or  con- 
vulfion  of  the  mufcles  of  the  face,  or  trick,  attends  thefe  patients 
in  the  few  cafes  which  I  have  witnefled,  though  this  may  poffi- 
.-•ccur  occafionally  asthe  confequence  of  difagreeable  fenfation, 
or  to  relieve  it.  I  fuppofe  the  word  tic  douloureux  is  a  vulgar 
French  exprefiion,  like  megrim  in  Englifh. 

The  caufe  of  this  afflicting  difeafe  is  yet  unknown.  As  it 
does  not  appear  to  fympathize  with  a  difeafed  tooth,  like  the  he- 
micrania  fymparhetica,  defcribed  in  Clafs  IV.  2.  2.  8.  I  fuf- 
pecl:  the  caufe  to  confift  in  a  difeafed  flate  of  the  nerve  itfelf,  or 
of  its  covering  or  theca,  and  to  refemble  the  fciatica  frigid?., 
mentioned  below ;  or  to  refemble  fome  of  thofe  pains,  which  are 
•fucceeded  or  relieved  by  epileptic  convulfions,  defcribed  in  Clafs 
III.  i.  i.  8.  and  that  it  thus  differs  from  the  hemicrania  fym- 
pathetica ;  as  in  this  the  caufe  of  the  difeafe,  and  the  feat  ef  the 
pain,  exift  in  the  fame  place. 

One  cafe,  which  occurred  to  me  long  ago,  of  this  difeafe,  was 
of  an  elderly  gentleman,  Mr.  W.  of  Litchfield,  who  had  long 
loft  all  his  teeth  ;  the  pain  began  chiefly  about  the  cheek-bone, 
and  extended  fometimes  to  the  ala  of  the  nofe,  and  to  other  parts 
of  the  face  on  the  fame  fide  ;  on  examining  the  gums  of  the  up- 
per jaw,  there  was  no  fufpicion  of  any  flump  of  a  decayed  tootb 

remaining 


1 1 6  DISEASES  CLASS  I.  2.  4. 1 2. 

remaining  in  the  alveolar  procefles  ;  nor  was  there  any  reafon  to 
fufpect  any  difeafe  of  the  maxillary  finus.  Whence  this  did  not 
appear  to  be  any  kind  of  fympathetic  hemicrania.  He  was  af- 
flicted with  it  for  many  years  till  his  death. 

The  cafe  of  Mr.  B.  a  gentleman  between  20  and  30  years  of 
age,  whom  I  was  lately  concerned  for,  in  this  difeafe,  is  well 
worthy  a  minute  defcription  ;  I  (hall  therefore  copy  a  letter,  which 
I  wrote  on  his  cafe  to  Mr.  Cruikfhank,  and  an  anfwer  J  receiv- 
ed fome  time  after  from  his  partner,  Mr.  Leigh  Thomas,  who  I 
hope  will  publifli  the  fuccefsful  method  of  cure,  with  adapte4 
prints. 

To  Mr.  Cruikjbank. 

Sir,  Derby,  Dec.   1798. 

Mr.  Bofworth,  whofe  cafe  I  wifh  to  remind  you  of,  confulted 
you  fome  time  ago  in  London,  and  I  believe  that  you  then  told 
him,  that  his  head-ach  was  owing  to  a  difeafe  of  the  third  branch 
of  the  fifth  pair  of  nerves.  He  came  under  my  care  at  Derby  a 
few  weeks  ago,  and  complained  of  much  pain  about  the  left 
cheek-bone  ;  Ifufpe&ed  the  antrum  maxillare  might  be  difeafed, 
and  as  the  fecond  of  the  dentes  molares  had  then  been  lately  ex- 
tracted, I  defired  a  perforation  might  be  made  into  the  antrum, 
-which  was  done  by  Mr.  Hadley,  of  this  town,  and  kept  open 
for  two  or  three  days  without  advantage.  Afterwards,  by  fric- 
tion about  the  head  and  neck  with  mercurial  unguent,  he  was 
copioufly  falivated  for  a  few  days,  and  had  another  tooth  extract- 
ed by  his  own  defire,  and  had  laftly  an  incifion  made  by  Mr. 
Hadley,  fo  as  to  divide  the  artery  near  the  centre  of  the  ear  next 
the  cheek,  hoping  to  divide  a  branch  of  the  affected  nerve,  but 
without  fuccefs  ;  and  internally,  opiates  in  large  quantity  were 
given,  when  the  pain  was  exceedingly  violent,  the  bark  alfo  was 
ufed  for  a  time  in  large  Quantity  without  effect. 

On  attending,  as  much  as  I  could,  to  his  fenfations  when  in 
pain,  he  feems  to  exprefs  the  commencement  of  the  periods  of 
pain  to  exift  about  the  part  of  the  left  cheek  before  the  middle 
of  the  ear  ;  and  then  draws  his  finger  from  thence  to  the  fore 
part  of  the  lower  jaw  fometimes,  and  to  the  ala  of  the  nofe  on 
that  fide  ;  and  at  other  times  he  draws  his  finger  from  the  fame 
part  of  the  cheek  before  the  ear  upwards  to  the  orbit  of  the  eye, 
and  from  thence  downwards,  a  little  way  on  the  nofe  ;  and  alfo 
he  complains  of  pain  under  his  tongue  on  the  fame  fide.  The 
pain  returns  many  times  in  an  hour  on  fome  days,  and  continues 
many  minutes,  during  which  he  feems  to  ilretch  and  exert  hir 
arms,  and  appears  to  have  a  tendency  to  epileptic  actions  ;  am 

his 


CLASS  I.  2.  4.  12.     OF  IRRITATION.  117 

his  life  is  thus  miferable  to  himfelf,  and  uncomfortable  for  his 
friends  to  witnefs. 

I  write  this  to  you  to  beg  that  you  will  acquaint  Mr.  Bof- 
worth,  whether  you  think  you  could  divide  by  incifion  the  dif- 
tafcd  nerve  ;  as  he  is  willing  to  undergo  fuch  an  operation,  if 
you  think  it  practicable,  as  I  believe  it  to  be  the  only  means, 
which  promiies  to  cure  him  ;  and  have  therefore  advifed  him 
again  to  apply  to  you ;  and  if  you  think  this  can  be  done  with 
eitect,  he  defigns  to  wait  on  you  in  London. 

I  am,  fir,  &c. 

E.  DARWIN. 

The  following  anfwer  of  Mr.  Leigh  Thomas  (hews  the  difeafe 
to  have  exifted  in  every  branch  of  the  affected  nerve. 

Sir,  Leicefter-fquarg)  May>  1799. 

About  the  middle  of  December  laft,  you  did  Mr.  Cruikfhank 
the  favour  to  write  him  an  accounj:  of  Mr.  Bofworth,  a  young 
gentleman,  fome  time  under  your  care  at  Derby,  with  a  painful 
affection  of  the  nerves  of  his  face.  The  patient  foon  after  carme 
to  town  in  a  much  worfe  (late,  than  you  defcribed  him  to  be  at 
that  time ;  as  the  pain  was  extremely  acute  and  almoft  unremit- 
ting, opiates,  which  he  had  been  in  the  habit  of  taking  occafion- 
aliy,  afforded  him  now  little  or  no  relief,  though  taken  to  the 
quantity  of  fix  tea-fpoonfuls  of  laudanum  at  a  time.  After  pay- 
ing every  attention  to  the  cafe,  your  fuggeftion  of  the  neceffity 
of  dividing  the  difeafed  nerve  appeared  obvious. 

As  the  pain  was  felt  more  acute  in  the  left  ala  of  the  nofe,  and 
the  upper  lip  of  the  fame  fide,  we  were  induced  to  divide  the 
fecond  branch  of  the  fifth  pair  of  nerves,  as  it  pafles  out  at  the  in- 
fraorbital  foramen.  He  was  inftantly  relieved  in  the  nofe  and 
lip  ;  but  towards  night  the  pain  from  the  eye  to  the  crown  of 
the  head  became  more  acute  than  ever.  Two  days  after,  we 
were  obliged  to  cut  through  the  firft  branch  pailing  out  at  the 
fupra-orbital  foramen  ;  this  afforded  him  the  like  relief  with  the 
firft.  On  the  fame  day  the  pain  attacked,  with  great  violence, 
the  lower  lip  on  the  left  fide,  and  the  chin  ;  this  circumftance 
induced  the  neceffity  of  dividing  the  third  branch  palling  out  at 
the  foramen  mentale.  During  the  whole  period,  from  the  firft 
divifion  of  the  nerves,  he  had  frequent  attacks  of  pain  on  the 
fide  of  the  tongue  ;  thcfe  however  difappeared  on  diviiion  of  the 
laft  nerve. 

Mr.  Cruikfhank  performed  the  above  operations,  but  being 
particularly  engaged  at  this  time  with  lectures  and  other  bufi- 
nefs,  he  now  gave  up  the  cafe  to  my  management.  The  patient 
was  evidently  bettered  by  each  operation  ;  (till  the  pain  was  very 

fevere, 


1 i *  DISEASES  CLASS  I.  2. 4.  z  2; 

fevere,  paffing  from  the  ear  under  the  zygoma  towards  the  nofe 
and  mouth,  and  upwards  round  the  orbit.  This  route  proved 
pretty  clearly,  that  the  portio  dura  of  the  auditory  nerve  was  al- 
fo  affected  ;  at  lead  the  uppermoft  branch  of  the  pes  anferinus. 
Before  I  proceeded  to  divide  this,  I  was  willing  to  try  the  effect  of 
arfenic  internally,  and  he  took  it  in  fufficienc  quantity  to  excite 
naufea  and  vertigo,  but  without  perceiving  any  good  effeih 

I  could  now  truft  only  to  the  knife  to  alleviate  his  mifery,  as 
the  pain  round  the  orbit  was  become  moft  violent ;  and  therefore 
intercepted  the  nerve  by  an  incifion  acrofs  the  fide  of  the  nofe, 
and  alfo  made  fome  fmalier  incifions  about  the  ala  nafi.  To  di- 
vide the  great  branch  lying  below  the  zygomatic  procefs,  I  found 
it  neceffary  to  pafs  the  fcalpel  through  the  maffeter  mufcle,  till 
it  came  in  contact  with  the  jaw-bone,  and  then  to  cut  upwards  5 
this  relieved  him  as  ufual.  Then  the  lower  branch  was  affect- 
ed, and  alfo  divided  :  then  the  middle  branch  running  under  the 
parotid  gland.  In  cutting  this,  the  gland  was  confequently  di- 
vided into  two  equal  parts,  and  healed  tolerably  well  after  a  co- 
pious difcharge  of  faliva  for  feveral  days. 

I  hoped  and  expected,  that  this  laft  operation  would  have  ter- 
minated his  fufferings  and  my  difficulties ;  but  the  pain  ftill  af- 
fected the  lower  lip  and  fide  of  the  nofe,  and  upon  coughing,  or 
fwallowing,  his  mifery  was  dreadful.  This  pain  could  only  arife 
from  branches  from  the  fecond  of  the  fifth  pair  paffing  into  the 
cheek,  and  lying  between  the  pterygoideus  internus  mufcle,  and 
the  upper  part  of  the  lower  jaw.  The  fituation  of  this  nerve 
rendered  the  operation  hazardous,  but  after  fome  attempts  it 
was  accompli  flied,  and  this  day  hefet  out  for  Leicefterfhire  per* 
fectly  reftored. 

I  am,  fir,  &c. 

LEIGH  THOMAS, 

Since  I  wrote  the  above,  I  have  feen  an  equally  deplorable  and 
inflructive  cafe,  of  hemicrania  idiopathica,  of  an  elderly  perfon, 
defcribed  by  Dr.  Haighton,  under  the  name  of  tic  douloureux, 
with  an  equally  fuccefsful  cure,  by  dividing  the  difeafed  nerves. 
Medical  Records  and  Refearches.  Cox,  London. 

Two  cafes  of  tic  douloureux  are  related  by  a  Dr.  Watfon,  in 
the  Recueil  periodique  de  Medecine,  Paris,  1798,  torn.  IV. 
which  are  faid  to  have  fubmitted  to  mercurial  frictions  and  warm 
bathing.  Thefe  pains  were  probably  venereal  fymptoms,  as  the 
author  fufpccts  ;  but  would  perfuade  us  again  to  try  the  ufe  of 
mercury,  though  itfaibd  in  the  cife  above  related,  and  efpecially 
:is  it  fometimes  fucceeih  in  the  hemicrania  fympathetica,  as  men- 
tioned in  Clafs  IV.  2.  2.  8.  Five  grains  of  the  powdered  leaf  of 

belladonna 


CLASS  I.  2,  4.  13.        OF  IRRITATION.  1 19 

belladonna  are  faid  to  have  been  fuccefsful.     See  Cephalsea  idio. 
pathica. 

13.  Odontalgia.  Tooth-ach.  The  pain  has  been  erroneoufly 
fuppoled,  where  there  is  no  inflammation,  to  be  owing  to  fome 
acrid  matter  from  a  carious  tootli  ftimulating  the  membrane  of 
the  alveolar  procefs  into  violent  action  and  confequent  pain  ; 
but  the  effect  Teems  to  have  been  miftaken  for  the  caufe,  and 
the  decay  of  the  tooth  to  have  been  occafioned  by  the  torpor 
and  confequent  pain  of  the  diieafed  membrane. 

Firft,  becaufe  the  pain  precedes  the  decay  of  the  tooth  in  re- 
gard to  time,  and  is  liable  to  recur,  frequently  for  years,  without 
certainly  being  fucceeded  at  laft  by  a  carious  tooth,  as  I  have 
repeatedly  obferved. 

Secondly,  becaufe  any  ftimulant  drug,  as  pyrethrum,  or  oil  of 
cloves,  applied  to  the  tooth,  or  ether  applied  externally  to  the 
cheek,  is  fo  far  from  increasing  the  pain,  as  it  would  do  if  the 
pained  membrane  already  acted  too  ftrongly,  that  it  frequently 
gives  immediate  relief  like  a  charm. 

And  thirdly,  becaufe  the  torpor,  or  deficient  action  of  the 
Kiembrane,  which  includes  the  difeafed  tooth,  occafions  the  mo- 
tions" of  the  membranes  moil  connected  with  it,  as  thofe  of  the 
cheek  and  temples,  to  act  with  lefs  than  their  natural  energy  ; 
and  hence  a  coldnefs  of  the  cheek  is  perceived  eafily  by  the  hand 
of  the  patient,  comparing  it  with  the  other  cheek  ;  and  the  pain 
of  hemicrania  is  often  produced  in  the  temple  of  the  affected  fide. 
This  coldnefs  of  the  cheek  in  common  tooth-ach  evinces,  that 
the  pain  is  not  then  caufed  by  inflammation  ;  becaufe  in  all  in- 
ilimnuuions  fo  much  heat  is  produced  in  the  fecretions  of  new 
Is  and  fluids,  as  to  give  heat  to  the  parts  in  the  vicinity. 
And  hence,  as  foon  as  the  gum  fwells  and  inflames  along  with 
the  cheek,  heat  ij  produced,  and  the  pain  ceafes,  owing  to  the 
increafed  exertions  of  the  torpid  membrane,  excited  by  the  ac- 
tivity of  the  fenibrial  power  of  fenfation  ;  which  previoufly  exift- 
ed  in  its  pafiive  flute  in  the  painful  torpid  membrane.  See 
Odontitis,  Ciais  II,  1.4.  7.  and  IV.  2.  2.  8. 

M.  M.  If  the  painful  tooth  be  found,  venefection.     Then  a 
cathartic.     Afterwards  two  grains   of  opium.     Camphor  and 
opium,  one  grain  of  each  held  in  the  rnou:h  ;  or  a  drop  or  two 
o.;:  oil  of  cloves  put  on  the  painful   tooth.     Ether.     If  the  tooth 
imall  hole  in  it,  this  fhould  be  widened  within  by  eu.  inUru- 
nient,  and  then  (lopped  with  leaf-gold,  or  leaf-lead  ;  but  the  truth 
ihould  be  extracted,  if  much  decayed.     It  is  probable  that  half  a 
drop  of  a  ilrong  folution  of  arfenic,  put  carefully  into  the 
hollow  of  a  decayed  aching  tooth,  would  deilvoy  the  nerve  with- 
out giving  any  additional  pain :  but  this  experiment  requires 

great 


12©  DISEASES  CLASS  I.  2. 4.  13. 

great  caution  left  any  of  the  folution  fhould  touch  the  tongue  or 
gums. 

Much  cold  and  much  heat  are  equally  injurious  to  the  teeth, 
which  are  endued  with  a  fine  fenfation  of  this  univerfal  fluid. 
The  beft  method  of  preferving  them  is  by  the  daily  ufe  of  a  brufh, 
which  is  not  very  hard,  with  warm  water  and  fine  charcoal  dud. 
A  lump  of  charcoal  mould  be  put  a  fecond  time  into  the  fire  till 
it  is  red  hot,  as  foon  as  it  becomes  cool  the  external  afhes  mould 
be  blown  off,  and  it  fhould  be  immediately  reduced  to  fine  pow- 
der in  a  mortar,  and  kept  clofe  (topped  in  a  phial.  It  takes  away 
the  bad  fmell  from  decayed  teeth,  by  warning  the  mouth  with 
this  powder  difFufed  in  water,  immediately.  The  putrid  fmell 
of  decaying  (lumps  of  teeth  may  be  deflroyed  for  a  time  by  warn- 
ing the  mouth  with  a  weak  folution  of  alum  in  water.  If  the 
calcareous  cruft  upon  the  teeth  adheres  very  firmly,  a  fine  pow- 
der of  pumice-ftone  may  be  ufed  occafionally,  or  a  tooth-inftru- 
ment. 

Acid  of  fea-falt,  much  diluted,  may  be  ufed  j  but  this  very 
rarely,  and  with  the  greateft  caution,  as  in  cleaning  fea-fhells. 
When  the  gums  are  fpongy,  they  mould  be  frequently  pricked 
with  a  lancet.  Should  black  fpots  in  teeth  be  cut  out  ?  Does 
the  enamel  grow  again  when  it  has  been  perforated  or  abraded  ? 

Qtalgia.  Ear-ach  fometimes  continues  many  days  without  ap- 
parent inflammation,  and  is  then  frequently  removed  by  filling 
the  ear  with  laudanum,  or  with  ether  ;  or  even  with  warm  oil, 
or  warm  water.  See  Clafs  II.  I.  4.  8.  This  pain  of  the  ear, 
like  hemicrania,  is  frequently  the  confequence  of  aflbciation  with 
•a  difeafed  tooth  •,  in  that  cafe  the  ether  mould  be  applied  to  the 
cheek  over  the  fufpecled  tooth,  or  a  grain  of  opium  and  as  much 
camphor  mixed  together,  and  applied  to  the  fufpected  tooth.  In 
this  cafe  the  otalgia  belongs  to  the  fourth  clafs  of  difeafes. 

14.  Pleurodyne  chronica.  Chronical  pain  of  the  fide.  Pains 
of  the  membranous  parts,  which  are  not  attended  with  fever, 
have  acquired  the  general  name  of  rheumatic  ;  which  fhould, 
neverthelefs,  be  reflricted  to  thofe  pains  which  exifl  only  when 
the  parts  are  in  motion,  and  which  have  been  left  after  inflam- 
mation of  them  ;  as  defcribed  in  Clafs  I.  I.  3.  12.  The  pain  of 
the  fide  here  mentioned  affects  many  ladies,  and  may  poilibly 
have  been  owing  to  the  prefTure  of  tight  (lays,  which  has  weak- 
ened the  action  of  the  veflels  compofing  fome  membranous  part, 
us,  like  the  cold  head-ach,  it  is  attended  with  prefent  debility  ; 
in  one  patient,  a  boy  about  ten  years  old,  it  wa^  attended  with 
daily  convulfions,  and  was  fuppofed  to  have  originated  from 
worms.  The  difeafe^is  very  frequent,  and  generally  withftands 
the  ufe  of  bliflers  on  the  part ;  but  in  fome  cafes  I  have  known 

it 


CLASS  I.  2.  4.  14.         OF  IRRITATION.  i.-r 

:noved  b;  rks  repeated  every  day  fora 

ugh  the  atTec"led  i', 

•:is  of  rhe  fide  may  be  fometimes  occasioned  by   the  adhe- 
fion  of  the  lungs  to  the 'pie,.  an    inlla 

•  the  aclhefioa  of  fome  abdominal   vifcera  to  their  cavity,  or 
to  each  other;   which  alfo    are   iu!>re  liable  to  aire-il  ladies  from 
the  unnatural  and  Ungraceful  preflure  of  tight  itays,  or  by  fil 
'or  lying  too   long  in  one  po'iture.     But  in    theic   cafes  the  pain 
fiioukl  be  more  of  the  im  art  ing,  than  of  the  dull  kind. 

M.  M.  Ether.  A  Milter.  A  plaller  of  Burgundy  pitch. 
An  iifue  or  feton  on  the  part.  Electric  i'hoeks.  Fridion  on 
the  part  with  oil  and  camphor.  Loole  drefs.  Frequent  ch.m  ^ 
of  poflure  both  in  the  day  and  night.  Internally,  opium,  vaj»- 
rian,  bark. 

15.  SciitL-a  jrigidfi.     Cold   fciatica.     The  pain   along   the 
courfe  of  the    fciatic  nerve,  from  the  hip  quite  down  to  the  top 
of  the  foot,  when  it  is  not  attended  with  fever,  u   improperly 
termed  either  rhetimatifm  or  gout  •,  as  it  occurs  without  inilani- 
rnation,  is  attended  with  pain  when  the  limb  is  at   reft  ;  and  as 
the  pain  attends  the  courfe  of  the  nerve,  and  not  the  courfe  of 
the  mufcles,  or  of  the  fafcia  which  contains  them.     The  theory 
of  Cotunnius,  who  believed  it  to  be  a  dropfy  of  the  (heath  of  the 
nerve,  which  was  compreiTed  by  the  accumulated  fluid,  Ins  not 
been  confirmed  by  difleclion.     The  dileafe  ieems  to  coniiil  of  a 
torpor  of  this  fheath  of  the  nerve,  and  the  pain  ieems  (o  be  in 
confequence  of  this  torpor.     Sse  Clafs  II.    1.2.   17. 

IvI.  M.  Venefe£tioii.  A  cathartic.  And  then  one  grain  of 
calomel  and  one  of  opium  every  night  for  ten  fucceil^ve  nights. 
And  a  blilter,  at  the  fame  time,  a  little  above  the  knee- joint  on 
the  outfide  of  the  thigh,  where  the  fciatic  nerve  is  nol 

.1.     Warm  bath.     Cold  bath.     Cover  the  limb   with  - 
iilk,  or  with  a  plafter-bandage  ofempladrum  de  mi:ii:). 

1 6.  Lumbago  frigida.      Cold    lumbago.      Yv'hen   no  fever  or 
inflammation  attends  this  pain  of  the  loins,  and  tiie  pain  exiits 
without  motion,  it  belongs  to  this  genus  of  difeaies,  and  TV 

die  pain  of  the  loins  in  the  cold  (it  of  ague.      As  th. 
branes  are  extenfive,  and  more  eafily  fall  into  qu'u-  iher 

by  fympathy,  or  wlien    they  are  primarily  affecled,  th- 
becomes  yery  afflicling,  and  of  great  per.  ifs  II. 

I.    2.     I?. 

M.  M.     Venefecl:ion.     A    cathartic.     IfTues   on    the   Icins. 
five  plafter  fp  the  loins.    Blifter  on  the  c  urn, 

bath.     Cold  bath.      Remove  to  a  warmer  climate  in  the  v/incer. 

x>ut  the  waiil.     Fri-ftioii  daily  wl-:i: 
r-!ior. 

VOL.   II.  R  1.   H-^-aliih 


1 2  2  DISEASES  CLASS  I.  2. 4.  1 7, 

i  7,  Hyjlerdlgia  frigida.  Cold  pain  of  the  uterus  preceding  or 
accompanying  menftruation.  It  is  attended  with  cold  extremi- 
ties, want  of  appetite,  and  other  marks  of  general  debility. 

M.  M.  A  clyfler  of  half  a  pint  of  gruel,  and  30  drops  of 
laudanum  ;  or  a  grain  of  opium  and  fix  grains  of  rhubarb  every 
night.  To  fit  over  warm  water,  or  go  into  a  warm  bath. 

1 8.  Protf algia  frigida.      Cold  pain  at  the  bottom  of   the  rec- 
tum previous  to  the  tumor  of  the  piles,  which  fometimes  extends 
by  fympathy  to  the  loins ;  it  feems  to   be  fimilar  to  the  pain  at 
the  beginning  of  menftruation,    and  is  owing  to   the  torpor  or 
inirritability  of  the  extremity  of  the  alimentary,  canal,  or  to  the 
obftru£tion  of  the  blood  in  its  paflage  through  the  liver,  when 
that  vifcus  is  afFefted,  and  its  confequent  delay  in  the  veins  of 
the  rectum,  occafioning  tumours  of  them,  and  dull  fenfations  of 
pain. 

M.  M.  Calomel.  A  cathartic.  Spice.  Clyfler,  with  30 
drops  of  laudanum.  Sitting  over  warm  water.  If  chalybeates 
after  evacuation  ?  See  Clafs  I.  2.  3.  23.  and  I.  2.  i.  6. 

19.  Vefica  fdlex  inirritabilitas.     The   inirritability  of  the  gall- 
bladder probably  occafions   one  kind    of  icterus ,  or  i^undice  ; 
which  is  owing  to  whatever  obftructs  the  paflage  of  bile  into  the 
duodenum.     The  jaundice   of  aged  people,  and  which  attends 
fome  fevers,  is  believed  to  be  moft  frequently  caufed  by  an  irri- 
tative palfy   of  the  gall-bladder;  on^Khich  account  the   bile  is 
not  prefled  from  the  cyil  by  its  contraction,  as  in  a  paralyfis  of 
the  urinary  bladder. 

A  thickening  of  the  coats  of  the  common  bile-duct  by  inflami- 
ination  or  increafed  action  of  their  vefTels  fo  as  to  prevent  the 
paflage  of  the  bile  into  the  inteftine,  in  the  fame  manner  as  the 
membrane,  which  lines  the  noftrils,  becomes  thickened  in  ca- 
tarrh fo  as  to  prevent  the  paflage  of  air  through  them,  is  proba- 
bly another  frequent  caufe  of  jaundice,  efpecially  of  children; 
and  generally  ceafes  in  about  a  fortnight,  like  a.  common  catarrh, 
without  the  aid  of  medicine  ;  which  has  given  rife  to  the  char- 
acter, which  charms  have  obtained  in  fome  countries  for  curing 
the  jaundice  of  young  people. 

The  fpiffitude  of  the  bile  is  another  caufe  of  jaundice,  as  men- 
tioned in  Ciafs  I.  r.  3.  8.  This  alfo  in  children  is  a  difeafe  of 
little  danger,  as  the  gall-ducts  are  diilenfible,  and  will  the  eafier 
admit  of  the  exclufion  of  gall-ftones  ;  but  becomes  a  more  feri- 
ous  difeafe  in  proportion  to  the  age  of  the  patient,  and  his  habits 
of  life  in  refpect  to  fpirituous  potation. 

A  fourth  caufe  of  jaundice  is  the  compreflion  of  the  bile-duct 
by  the  enlargement  of  an  inflamed  or  fcirrhous  liver  j  this  attends 

thofe 


CLASS  I.  2.  4.  20.       OF  IRRITATION.  123 

thofe  who  have  drunk  much  fpirituous  liquor,  and  is  generally 
fucceeded  by  dropiy  and  death. 

M.  M.  Repeated  emetics.  Mild  cathartics.  Warm  bath. 
Electricity.  Bitters.  Then  lieel,  which,  when  the  pain  and 
inflammation  are  removed  by  evacuations,  a£ts  like  a  charm  in 
removing  the  remainder  of  the  inflammation,  and  by  promoting 
the  abforption  of  the  new  veflels  or  fluids ;  like  the  application 
of  any  acrid  eye-water  at  the  end  of  ophthalmia  ;  and  thus  the 
thickened  coats  of  the  bile-daft  become  reduced,  or  the  enlarge- 
ment of  the  liver  leflened,  and  a  free  paiTige  is  again  opened  for 
the  bile  into  the  inteftine.  Ether  with  yolk  of  egg  is  recom- 
mended, as  having  a  tendency  to  diflblve  infpiflated  hile.  And 
a  decoction  of  madder  is  recommended  for  the  fame  purpofe  ; 
bscaufe  the  bile  of  animals,  whofe  food  was  mixed  with  madder, 
ound  always  in  a  dilute  flate.  Aerated  alkaline  water,  or 
Seltzer"  water.  Raw  cabbage,  and  other  acrid  vegetables,  as 
\vatcr-cr  jfles,  muftard.  Horfes  are  faid  to  be  fubject  to  infpif- 
fked  bile,  with  yellow  eyes,  in  the  winter  feafon,  and  to  get  vv.eii 
as  Toon  as  they  feed  on  the  fpring  grafs. 

The  largeft  bile-ftone  I  have  feen  was  from  a  lady,  who  had 
parted  with  it  fome  years  before,  and  who  had  abilained  above 
ten  years  from  all  kinds  of  vegetable  diet  to  prevent,  as  the 
fuppofed,  a  colic  of  her  ftomach,  which  was  probably  a  pain 
of  the  biliary  duct ;  on  reluming  the  ufe  of  fome  vegetable  diet, 
{he  recovered  a  better  ftate  of  health,  and  formed  no  new  bilious 
concretions. 

A  ftrong  aerated  alkaline  water  is  fold  by  J.  Schweppe,  No. 
8,  King-ftreet,  Holborn.  See  Clafs  I.  I.  3.  10. 

20.  Pelvis  renalis  inirritabilitas .  Inirritability  of  the  pelvis 
of  the  kidney.  When  the  nucleus  of  a  (tone,  whether  it  be  in- 
fpiflated  mucus,  or  other  matter,  is  formed  in  the  extremity  of 
any  of  the  tubuli  uriniferi,  and  being  detached  from  thence  falls 
into  the  pelvis  of  the  kidney,  it  is  liable  to  lodge  there  from  the 
want  of  due  irritability  of  the  membrane  ;  and  in  that  fituation 
increafes  by  new  apportions  of  indurated  animal  matter,  in  tli2 
fame  manner  as  the  ftone  of  the  bladder.  This  is  the  general 
caufe  of  haemorrhage  from  the  kidney  ;  and  of  obtufe  pain  in  it 
on  exercife  ;  or  of  acute  pain,  when  the  (lone  advances  into  thr 
ureter.  See  Clafs  I.  i.  3.  9. 


ORDO 


1 24  DISEASES  ,Ci-A3s  I.  2.  5.  i. 

ORDO  II. 

Decreased  Irritation. 

GENUS  V. 

Decreafed  A&icn  of  the  Organs  of  Scnfc. 
SPECIES. 

I.  Stxhittainirritabititaf.  Folly  from  inirritability.  Dulneu 
of  perception.  When  the  motions  of  the  fibrous  extremities 
of  the  nerves  of  fenfe  are  too  weak,  to  excite  fenfation  with  fuf- 
ficient  quicknefs  and  vigour.  The  irritative  ideas  are  neverthe- 
performed,  thongli  perhaps  in  a  feeble  manner,  as  fuch  peo- 
ple do  not  run  againtl  a  poft,  or  walk  into  a  well.  There  are 
three  other  kinds  of  folly ;  that  from  deficient  fenfation,  from 
deficient  volition,  and  from  deficient  affociation,  as  will  be  men- 
tioned in  their  places.  In  delirium,  reverie,and  fleep,  the  pow- 
er of  perception  is  abolifhed  from  other  caufes. 

2.  Vifus  hnwinutus.  Diminifhed  vifion.  In  our  approach  to 
old  age  our  viilon  becomes  imperfect,  not  only  from  the. form  cf 
the  cornea,  which  becomes  lefs  convex,  and  from'  its  decreafed 
tranfparency  mentioned  in  Clafs  I.  I.  3.  14  ;  but  alfo  from  the 
decreafed  irritability  of  the  optic  nerve.  Thus,  in  the  inirritative 
or  nervous  fever,  the  pupil  of  the  eye  becomes  dilated  ;  which  in 
this,  as  well  as  in  the  dropfy  of  the  brain,  is  generally  a  fatal 
iyinptom.  A  part  of  the  cornea  as  well  as  a  part  of  the  albugi- 
iiea  in  thefe  fevers  is  frequently  feen  during  fleep  ,  which  is  ow- 
ing to  the  inirfitability  of  the  retina  to  light,  ov  to  the  general 
parefis  of  mufcylar  aQion,  and  in  confeqence  to  the  lefs  contrac- 
tion of  the  fphincter  pf  the  eye,  if  it  may  be  fo  called,  at  that 
time. 

In  fome  eyes  there  is  an  inaptitude  to  adapt  themfelves  t 
the  perception  of  objects  at  different  diftarices,  which  I  fuppofe 
may  be  owing  to  the  inirritability  of  thofe  mufcular  fibres,  which 
conftitute  the  ciliary  procefs,  fo  well  defcribed  and  explained  by 
Dr.  Porter  field,  afcd  in  the  Scots  Medical  EiTays,  and  fo  elegany- 
ly  feen  in  a  differed  eye.  It  was  formerly  believed,  and  has  in- 
deed lately  been  again  pretended,  that  the  focus  of  the  cryftal-- 
1'ine  humour  was  adapted  to  objects  at  different  diftances  by  a 
change  of  the  fhape  of  the  whole  eye  by  the  action  of  the  exter- 
nal mufcles,  which  are  inferted  into  the  tunica  albuginea,  and 
j_;ive  motion  to  it  in  every  direction  :  but  in  an  f  '  is  may  be 

obferved| 


CI.ASS  I.  2.  5.  3.       OF  IRRITATION.  125 

oofen  '  common  afHons  of  the  mufcles  affected  the 

focus  of  the  eye,  every  motion  of  the  eye-ball,  when  we  attend 
to  objects  at  any  diflance,  mud  diilurb  our  vifion.  At  the  fame 
time  though  it  is  pofiible,  that  a  violent  action  of  ail  the  mufcles 
together,  fo  as  to  counter-balance  each  other,  and  keep  the  eye 
motionlefs,  as  when  we  look  painfully  at  a  very  diftant  object, 
may  in  fome  degree  afreet  the  form  of  it ;  yet  that  the  contrac- 
tion of  the  ciliary  procefs  perpetually  adapts  the  focus  of  the  cryf- 
talliiie  lens  to  the  diftance  of  the  retina  is  not  to  be  difputed. 

There  have  bcen.inftances  of  fome,  who  could  not  diftinguifii 
certain  colours ;  and  yet  \\hcfe  eyes,  in  other  refpecls,  were  not 
imperfect.  Philof.  Traufact.  Which  feems  to  have  been 
owing  to  the  want  of  irritability ,  .or  the  inaptitude  to  action,  of 
fome  clafles  of  fibres  which  compofe  the  retina.  Other  perma- 
nent defects  depend  on  the  difeaied  ftate  of  the  external  organ, 
i.  i.  3.  14. 1.  2.  2.  13.  IV.  2.  i.  n. 

3.  MnfLiE  wiitantes.  Dark  fpots  appearing  before  the  eyes, 
and  changing  their  apparent  place  with  the  motions  of  the  eyes, 
are  owing  to  a  temporary  defect  of  irritability  of  thole  parts  of 
jthe  retina,  which  have  been  lately  expofed  to  more  luminous  ob- 
jects than  the  other  parts  of  it,  as  explained  in  Seel.  XL.  2. 
Hence  dark  fpots  are  feen  cm  the  bed-clothes  by  patients,  when 
the  optic  nerve  is  become  lefs  irritable,  as  in  fevers  with  great 
debility  j  and  the  patients  are  perpetually  trying  to  pick  them  off 
with  their  fingers  to  difcover  what  they  are  ;  for  thefe  parts  of 
the  retina  of  weak  people  are  fooner  exuaufted  by  the  ftimulus 
of  bright  colours,  and  are  longer  in  regaining  their  irritability. 

Other  kinds  of  ocular  fpectra,  as  the  coloured  ones,  are  alfo 
more  liable  to  remain  in  the  eyes  of  people  debilitated  by  fevers, 
and  to  produce  various  hallucinations  of  fight.  For  after  the 
contraction  of  a  mufcle,  the  fibres  of  it  continue  in  the  kft  fitu- 
ation,  till  fome  antagonift  mufcles  are  exerted  to  retract  them  ; 
whence,  when  any  one  is  much  exhaufted  by  exercife,  or  by  want 
of  deep,  or  in  fevers,  it  is  eafier  to  let  the  fibres  of  the  retina  re- 
main in  their  lad  fituation,  after  having  been  ftimulated  into 
contraction,  than  to  exert  any^antagoniit  fibres  to  replace  them. 

As  the  optic  nerves  at  their  entrance  into  the  eyes  are  each  of 
th,em  as  thick  as  a  crow-quill,  it  appears  that  a  great  quantity  of 
fenforial  power  is  expended  during  the  day  in  the  perpetual  ac- 
tivity of  our  fenfe  of  viiion,  befides  that  ufed  in  the  motions  of 
the  eye-balls  and  eye-lids ;  as  much  I  fuppofe  as  is  expended  in 
the  motions  of  our  arms,  which  are  fupplied  with  nerve ;  of 
about  the  fame  diameters.  From  hence  we  may  conclude,  that 
the"  light  fhould  be  kept  ,rom  patients  in  fevers  with  debility,  to 
prevent  the  unneceifary  exh  ;  of  the  fenfcvial  power. 

And 


126  DISEASES  CLASS  I.  2. $. 4. 

And  that  on  the  fame  account  their  rooms  fhould  be  kept  filent 
as  well  as  dark  j  that  they  ihould  be  at  reft  in  a  horizontal  pof- 
ttire ;  and  be  cooled  by  a  blaft  of  cool  air,  or  by  wafhing  them 
with  cold  water,  whenever  their  fkins  are  warmer  than  natural. 

4.  Strabifmus.     Squinting   is  generally  owing  to  one  eye  be- 
ing lefs  perfect  than   the   other  ;  on  which  account  the  patient 
endeavours  to  hide  the  worft  eye  in  the  fhadow  of  the  nofe,  that 
his  vilion  by  the  other  may  not    be  confufed.     Calves  which 
have  an  hydatide  with  infects  inclofed.  in  it  in  the  frontal  finus 
on  one  fide,  turn  towards    the  affected  fide  j  becaufe  the  vifion 
on  that  fide,  by  the  preflure  of  the  hydatide,  becomes  lefs  per- 
fect ;  and  the  difeafe  being  recent,  the  animal  turns  round,  ex- 
pecting to  get  a  more  diftinct  view  of  objects. 

In  the  hydrocephalus  internus,  where  both  eyes  are  not  be- 
come infenfible,  the  patient  fquints  with  only  one  eye,  and  views 
objects  with  the  other,  as  in  common  ftrabifmus.  In  this  cafe 
it  may  be  known  on  which  fide  the  difeafe  exifts,  and  that  it 
does  not  exift  on  both  fides  of  the  brain  ;  in  fuch  circumstances, 
as  the  patients  I  believe  never  recover  as  they  are  now  treated, 
might  it  not  be  advifeable  to  perforate  the  cranium  over  the  ven- 
tricule  of  the  affected  fide  ?  which  might  at  lead  give  room  and 
ilimulus  to  the  affected  part  of  the  brain  ? 

M.  M.  If  the  fquinting  has  not  been  confirmed  by  long  habit, 
and  one  eye  be  not  much  worfe  than  the  other,  a  piece  of 
gauze  flretched  on  a  circle  of  whale-bone,  to  cover  the  beft  eye 
in  fuch  a  manner  as  to  reduce  the  diftinctnefs  of  vifion  of  this 
eye  to  a  fimilar  degree  of  imperfection  with  the  other,  fhould  be 
•worn  fome  hours  every  day.  Or  the  better  eye  ihould  be  total- 
ly darkened  by  a  tin  cup  covered  with  black  filk  for  fome  hours 
daily,  by  which  means  the  better  eye  will  be  gradually  weak- 
ened by  the  want  of  life,  and  the  worfe  eye  will  be  gradually 
ilrengtheried  by  ufing  it.  Covering  an  inflamed  eye  in  chil- 
dren for  weeks  together,  is  very  liable  to  produce  fquinting,  for 
the  fame  reafon. 

5.  Amaurofis.     Guttaferena.  Is  a  blindnefs  from  the  inirritabil- 
ity  of  the  optic  nerve.  It  is  generally  efteemed  a  palfy  of  the  nerve, 
but  fhpuld  rather  be  deemed  the  death  of  it,  as  paralyfis  has  gener* 
ally  been  applied  to  a  deprivation  only  of  voluntary  power.    This 
is  a  difeafe  of  dark  eyes  only,  as  the  cataract  is  a  difeafe  of  light 
eyes  only.     At  the  commencement  of  this  difeafe,  very  minute 
electric  fhocks  mould  be  repeatedly  paffed  through  the  eyes ;  fuch 
as  may  be  produced  by  putting  one  edge  of  a  piece  of  filver  the 
fize  of  a  half  crown  piece  beneath  the  tongue,  and  one  edge  of  a 
piece  of  zinc  of  a  fimilar  fize  between  the  upper  lip  and  the  gum, 

and 


CLASS  I.  2.  5.  6.          OF  IRRITATION.  1 27 

and  then  repeatedly  bringing  their  exterior  edges  into  contact, 
by  which  means  very  fmall  eleftric  fparks  become  vifible  in  the 
eyes. 

Mrs.  T had  for  fome  weeks  complained  of  imperfect 

fight.  For  the  laft  fortnight  lhe  could  not  in  lefs  than  a  minute 
fpell  out  a  fingle  word  in  a  large  print.  Her  eyes  black,  and  the 
pupils  large.  Very  flight  electric  (hocks,  not  fparks,  were  pafled 
through  the  forepart  of  her  forehead  twice  a  day,  and  the  zinc 
and  filver  pencils  as  mentioned  below  were  ufed  many  times  a 
day.  iShe  took  valerian  and  columbo  internally,  and  regained  her 
fight  very  perfectly  in  about  three  weeks. 

I  ufed  in  the  above  cafe  a  more  convenient  and  efficacious 
method  of  galvanifm  by  employing  two  rods,  one  of  them  of  zinc 
about  the  fize  of  a  writing  pencil,  and  the  other  a  filver  pencil- 
cafe  about  the  fame  (ize  ;  and  by  putting  the  end  of  the  zinc 
rod  in  contact  with  the  external  corner  of  one  eye,  and  the  end 
of  the  filver  pencil-cafe  in  contacl;  with  the  external  corner  of  the 
other  eye,  and  then  repeatedly  making  the  other  ends  touch  each 
other  ;  fparks  will  be  vifible  in  the  eyes  both  at  the  time  of  con- 
tacl: and  at  the  time  of  feparation  of  the  two  rods.  This  experi- 
ment was  publifhed  by  Volta  fince  the  former  one  by  Galvani. 
See  Sea.  XIV.  5.  of  Vol.  I. 

A  foreign  phyfician,  proferTor  Arnemann,  has  lately  recom- 
mended the  production  of  vertigo  in  gutta  ferena,  as  he  fays,  to 
accumulate  more  blood  in  the  head.  If  this  mould  be  really 
found  of  advantage  the  patient  might  lie  on  a  large  mill-done,, 
which  might  be  fuffered  to  turn  flowly,  but  a  very  great  velocity 
of  the  whirling  ftone  might  occafion  ileep,  apoplexy,  and  death. 
See  Supl.  I.  15.  7. 

M.  M.  Minute  electric  mocks.  A  grain  of  opium,  and  a 
quarter  of  a  grain  of  corrofive  fublimate  of  mercury,  twice  a  day 
for  four  or  fix  weeks.  Blifter  on  the  crown  of  the  head.  Er- 
rhines,  fo  as  to  induce  violent  fneezing.  twice  a  day  for  a  week. 

6.  Audltus  itnmiiiutus.  Diminifhed  hearing.  Deafnefs  is  a 
frequent  fymptom  in  thofe  inflammatory  or  fenfitive  fevers  with 
debility,  which  are  generally  called  putrid  ;  it  attends  the  general 
ftupor  in  thofe  fevers,  and  is  rather  efteemed  a  falutary  fign,  as 
during  this  ftupor  there  is  lefs  expenditure  of  fenforial  power. 

In  fevers  of  debility  without  inflammation,  called  nervous  fe- 
vers, I  fufpecl:  cleafnefs  to  be  a  bad  fymptom,  arifing,  like  the  di- 
lated pupil,  from  a  partial  paralyfis  of  the  nerve  of  fenfe.  Sec 
ClnfslV.2.  i.  15.  ' 

Nervous  fevers  are  fuppofed  by  Dr.  Gilchrift  to  originate  from 
a  congeftion  of  ferum  or  water  in  feme  part  of  the  brain,  as  many 
of  the  fymptoms  are  fo  fimilar  to  thofe  of  hydrocephalus  inter- 


128  DISEASES  CLASS  I.  2.  5.  6. 

nus,  in  which  a  fluid  is  accumulated  in  the  ventricles  of  the 
brain  ;  on  this  idea  the  inactivity  of  the  optic  or  auditory  nerves 
in  thefe  fevers  may  arife  from  the  compreffion  of  the  efFufed  llukl ; 
While  the  torpor  attending  putrid  fever  may  depend  on  the  me- 
ninges  of  the  brain  being  thickened  by  inflammation,  and  thus 
compreliing  it  ;  now  the  new  veflels,  or  the  blood,  which  thick- 
ens inflamed  parrs^  is  more  frequently  re-abforbed,  than  the  ef- 
fufed  fluid  from  a  cavity  ;  and  hence  the  ftupor  in  one  cafe  is 
lefs  dangerous  than  in  the  other. 

In  inflammatory  or  fenfitive  fevers  with  debility,  deafnefs  may1 
fometimes  arife  from  a  greater  fecretioil  and  abforption  of  the 
ear-wax,  which  is  very  firnilar  to  the  bile,  and  is  liable  to  fill  the 
meatus  auditorius,  when  it  is  too  vifcid,  as  bile  obftrucls  the  gall- 
duels. 

M.  M.  In  deafnefs  without  fever,  Dr.  Darwin  applied  a  cup- 
ping-glafs  on  the  ea'r  with  good  effecfl,  as  defcribed  in  Phil. 
Tranf.  Vol.  LXIV.  p.  348.  Oil,  ether,  laudanum,  dropped  into 
the  ears.  Errhines.  Ele£r.ricity. 

If  ether  when  dropped  into  the  ears  be  not  very  pure,  it  is  lia- 
ble to  give  pain  ;  it  has  otherwife  the  property  both  of  diflblvirig 
the  ear-wax,  and  of  Simulating  torpid  parts  into  their  accuftom- 
ed  activity,  as  is  known  from  its  relieving  pains  from  inactivity 
of  the  pained  part,  as  tooth-ach  and  head-ach.  If  unredlifiedr 
ether  be  dirtilled  from  the  oxyde  of  manganefe,  the  oxygen  dif-- 
engaged  from  the  manganefe  is  afierted  to  convert  the  fulphurous 
into  fulphuric  acid,  which  is  then  not  difpofed  to  rife  in  diltilla- 
tion.  Journal  de  Phyfique,  April,  1 798.  And  that  this  is  the 
great  fecret  of  procuring  pure  ether,  and  it  will  then  give  no  pain 
on  being  dropped  into  the  ear.  See  Art.  II.  2.  3. 

Deafnefs  is  believed  fometimes  to  arife  from  obflruclion  of  the 
Euftachian  tubes,  which  communicate  from  the  fauces  to  the  in- 
ternal ear  behind  the  tympanum  ;  if  this  obftruclion  be  llight,  as 
by  infpiffated  mucus,  it  has  been  propoied  to  inject  the  Eufla- 
chian tubes  ;  and  it  is  faid,  that  if  the  deaf  perfon  frequently 
has  recourfe  to  the  fimple  action  of  fhutting  his  mouth  and  of 
clofing  his  noilrils  by  pinching  them  together  with  his  finger  and 
thumb,  and  then  forcibly  endeavours  to  prefs  the  breath  through 
his  nofe,  that  air  will  pafs  into  the  internal  ear  through  the  Eu- 
ftachian  tubes,  condenfing  that  air  which  exifls  behind  the  tym- 
panum ;  which  the  patient  will  himfelf  be  fenfible  of,  by  a  fen- 
fation  of  found  in  his  ears.  And  that  this  has  relieved  many. 

Where  an  eruption  occurs  in  the  ear,  followed  by  a  dry  fcale 
®r  fcab  at  the  bottom  of  the  meatus  auditorius,  a  foliation  of 
corrofive  fublimate  of  mercury,  hydfargyrus  muriatus,  about,  one 
grain  to  an  ounce  of  water,  dropped  into  the  ear,  frequently  has 

been 


CLA  7  OF  IRRITATION.  129 

ufed  with  advantage  by  Dr.  Darwin  of  Shrewibury.     See 
IV.  2.  i.  15. 

7.  Qlfaclus  imminutus.     Inactivity    of   the    fenfe    of   fmell. 
i  our  habits  of  trufting  to  the  art  of  cookery,  and  not  exam- 
ining our    iocd   by  the    fmell   as  other  animals  do,  our  fen 
fmell  is  lefs  perfect  than  theirs.     See  Sett.  XVI.  5.  Gab  i  V .  z. 
i.  16. 

M.  M.   Mild  errhines. 

8.  Guftus  imminutus.    Want  of  tafte  is  very  common  in  fevers, 
owing  frequently  to  the  drynefs  or  fcurf  of  the  tongue,  or  exter- 
nal organ  of  that  fenfe,  rather  than  to  any  injury  of  the  nerves  of 
taire.     See  Clafs  I.  i.  3.  i.lV.  2.  i.  16. 

M.  M.  Warm  fubacid  liquids  taken  frequently. 

9.  Tafius  imminutus.     Numbnefs  is  frequently  complained  of 
in  fevers,  and  in  epilepfy,  and  the  toilch  is   fometimes  impaired 
by  the  drynefs  of  the  cuticle  of  the  fingers.  See  Clafs  IV.  2.  i .  16. 

When  the  fenfe  of  touch  is  impaired  by  the  compreilion  of  the 
nerve,  as  in  fitting  long  with  one  thigh  croffed  over  the  other, 
the  linlb  appears  larger,  when  we  touch  it  with  our  hands, 
which  is  to  be  afcribed  to  the  indiltinctnefs  of  the  fenfation  of 
touch,  and  may  be  explained  in  the  fame  manner  as  the  appar- 
ent largenefs  of  objects  feen  through  a  milt.  In  this  laft  cafe 
the  minute  parts  of  an  object,  as  iuppofe  of  a  diitant  boy,  are 
feen  lefs  diftinctly,  and  therefore  we  infiantly  conceive  them  to 
be  further  from  the  eye,  and  in  coniequence  that  the  whole  fub- 
tends  a  larger  angle,  and  thus  we  believe  the  boy  to  be  a  man. 
»So  when  any  one's  fingers  are  preiTed  on  a  benumbed  limb,  the 
fenfation  produced  is  lefs"  than  it  mould  be,  judging  from  vifible 
ciicumftances  ;  we  therefore  conceive,  that  fomething  interve- 
ned between  the  object  and  the  fenfe,  for  it  is  felt  as  if  a  blank- 
et wasv  put  between  them;  and  that  not  b^ing  vifibiy  the  . 
\ve  judge  that  the  limb  is  fwelled. 

The  fenfe  of  touch  is  alfo  liable  to  be  deceived  from  the  ac- 
quired habits  of  one  part  of  it  acting  in  the  vicinity  of  another 
part  of  it.  Thus  if  the  middle  finger  be  crofted  over  either  of 
the  fingers  next  to  it,  and  a  nut  be  felt  by  the  two  ends  of  the 
fingers  Ib  croiTed  at  the  fame  time,  the  nut  appears  as  if  iL  was 
two  nuts.  And  Jaftly,  the  fenfe  of  touch  is  liable  to  be  deceived 
by  preconceived  ideas  j  which  we  believe  to  be  excited  by  exter- 
nal objects,  even  when  we  are  awake.  It  has  happened  to  n-c 
more  than  once,  and  I  fuppoie  to  rnoft  others,  to  have  put  my 
hands  into  an  empty  bafon,  (landing  in  an  obfcure  corner  of  a 
loom,  to  warn  them,  which  I  believed  to  contain  cold  water,  ami 
haveinftantly  perceived  a  fenfaiion  of  waniuli,  cuiifi-ary  to  th.it 
which  I  expected  to  have  felt. 

VOL.  II.  S  la 


13°  DISEASES  GLASS  1. 2. 5.  10, 

In  fome  paralytic  affections,  and  in  cold  fits  of  ague,  the  fen- 
fation  of  touch  has  been  much  impaired,  and  yet  that  of  heat  has 
remained.  See  Seel.  XIV.  6. 

M.  M.  Friaion  alone,  or  with  camphorated  oil,  warm  bath. 
Ether.  Volatile  alkali  and  water.  Internally,  fpice,  fait.  In- 
citantia.  Secernentia. 

lo.  Stupor.  The  ftupor,  which  occurs  in  fevers  with  debili- 
ty, is  generally  efteemed  a  favourable  fymptom  ;  which  may  arife 
from  the  lefs  expenditure  of  fenforial  power  already  exifting  in 
the  brain  and  nerves,  as  mentioned  in  fpecies  6  of  this  genus. 
But  if  we  fuppofe,  that  there  is  a  continued  production  of  fen- 
forial power,  or  an  accumulation  of  it  in  the  torpid  parts  of  the 
fyftem,  which  is  not  improbable,  becaufe  fuch  a  production  cf 
it  continues  during  fleep,  to  which  flupor  is  much  allied,  there 
is  ftill  further  reafon  for  believing  it  to  be  a  favourable  fymptom 
in  inirritable  fevers  ;  and  that  much  injury  it  often  done  by 
blifters  and  other  powerful  ftimuli  to  remove  the  ftupor.  See 
Seel:.  XII.  7.  8.  and  XXXIII.  i.  4. 

Dr.  Blane,  in  his  Croonian  Lecture  on  mufcular  motion,  for 
1788,  among  many  other  ingenious  obfervations  and  deductions, 
relates  a  curious  experiment  on  falmon,  and  other  fifh,  and  which 
he  repeated  upon  eels  with  limilar  event. 

"  If  a  fiih,  immediately  upon  being  taken  out  of  the  water,  is 
ftunned  by  a  violent  blow  on  the  head,  or  by  having  the  head 
crufhcd,  the  irritability  and  fweetnefs  of  the  mufcles  will  be  pre- 
ferved  much  longer,  than  if  it  had  been  allowed  to  die  with  the 
organs  of  fenfe  entire.  This  is  fo  well  known  to  nfhermen, 
that  they  put  it  in  practice,  in  order  to  make  them  longer  fufcep- 
tible  of  the  operation  called  crimping.  A  falmon  is  one  of  the 
fiih  leaft  tenacious  of  life,  infornuch,  that  it  will  lofe  all  figns  of 
life  in  lefs  than  half  an  hour  after  it  is  taken  out  of  the  water,  if 
fuffered  to  die  without  any  farther  injury ;  but  if,  immediately 
after  being  caught,  it  receives  a  violent  blow  on  the  head,  the 
mufcles  will  fhew  vifible  irritability  for  more  than  twelve  hours 
afterwards. 

Dr.  Blane  afterwards  well  remarks,  that,  u  in  thofe  diforders 
in  which  the  exercife  of  the  fenfes  is  in  a  great  meafure  deftroy- 
ed,  or  fufpended,  as  in  the  hydrocephalus,  and  apoplectic  palfy, 
it  happens,  not  uncommonly,  that  the  appetite  and  degeftion  are 
better  than  in  health." 


CLASS!.  3.  i.  OF  IRRITATION.  131 

ORDO  III. 

Retrograde  Irritative  Motions. 

GENUS  I. 
Of  the  Aliment  dry  CanaL 

THE  retrograde  motions  of  our  fyftern  originate  either  from 
.defect  of  ftiinulus,  or  from  defeat  of  irritability.  Thus  ficknefs 
is  often  induced  by  hunger,  which  is  a  want  of  ftimulus  ;  and 
from  ipecacuanha,  in  which  lad  cafe  it  would  feem,  that  the 
ficknefs  was  induced  after  the  violence  of  die  ftimulus  was  aba- 
ted, and  the  confequent  torpor  had  fucceeded.  Hence,  fpice, 
opium,  or  food,  relieves  ficknefs. 

The  globus  hyftericus,  falivation,  diabetes,  and  other  inver- 
fions  of  motion  attending  hyfteric  paroxyfms,  feem  to  depend 
on  the  want  of  irritability  of  thofe  parts  of  the  body,  became 
they  are  attended  with  cold  extremities,  and  general  debility,  and 
are  relieved  by  wine,  opium,  fteel,  and  fleih  diet  ;  that  is,  by 
any  additional  ftimulus. 

When  the  longitudinal  mufcles  are  fatigued  by  long  action,  or 
are  habitually  weaker  than  natural,  the  antagonift  mufcles  re- 
place the  limb  by  ftretching  it  in  a  contrary  direction  ;  and  as 
thefe  mufcles  have  had  their  actions  aflbciated  in  fynchronous 
tribes,  their  actions  ceafe  together.  But  as  the  hollow  mufcies 
propel  the  fluids,  which  they  contain,  by  motions  aflbciated  in 
trains  ;  when  one  ring  is  fatigued  from  its  too  great  debility,  and 
brought  into  retrograde  action ;  the  next  ring,  and  the  next, 
from  its  aflbciation  in  train  falls  into  retrograde  action.  Which 
continue  fo  long  as  they  are  excited  to  act,  like  the  tremors  of 
the  hands  of  infirm  people,  fo  long  as  they  endeavour  to  act. 
Now  as  thefe  hollow  mufcles  are  perpetually  (timulated,  thefe 
retrograde  actions  do  not  ceafe  as  the  tremors  of  the  longitudi- 
nal mufcles,  which  are  generally  excited  only  by  volition. 
Whence  the  retrograde  motions  of  hollow  mufcles  depend  on 
two  circumflances,  in  which  they  differ  from  the  longitudinal 
mufcles,  namely,  their  motions  being  aflbciated  in  trains,  and 
their  being  fubject  to  perpetual  ftimulus.  For  further  eluci- 
dation of  the  caufe  of  this  curious  fource  of  difeafes,  fee  Sect. 
XXIX.  ii.  5. 

The  fluids  difgorged  by  the  retrograde  motions  of  the  various 
vafcular  mufcles  maybe  diftinguilhed,  i.  From  thofe,  which 
are  produced  by  fecretion,  by  their  not  being  attended  by  increafe 


nni 


132  DISEASES  CLASS!.  3. 

of  heat,  which  always  accompanies  increafed  fecretion.  2.  They 
may  be  diftinguifhed  from  thofe  fluids,  which  are  the  confe- 
quence  of  deficient  abforption,  by  their  not  poiTeiTmg  the  falin 
acrimony,  which  thofe.  fluids  pofiefs  j  which  inflames  the  {km.  u 
other  membranes  on  which  they  fall ;  and  which  have  a  ialine 
tafte  to  the  tongue.  3.  They  may  >e  diitinguifhed  from  thofe 
fluids,  which  are  the  confequence  both  of  increafed  fecretion  and 
abforption,  as  thefe  are  attended  with  inCreafe  of  warmth,  and 
are  infpiflated  by  the  abftraction  of  their  aqeous  parts.  4. 
Where  chyle,  or  milk,  is  found  in  the  feces  or-  urine,  or  when 
other  fluids,  as  matter,  are  tranflated  from  one  part  of  the  fyftem 
to  another,  they  have  been  the  product  of  retrograde  action  of 
lymphatic  or  other  canals.  As  explained  in  Seel.  XXIX.  8. 


SPECIES. 


T.  Ruminatio.  In  the  rumination  of  horned  cattle  the  retro- 
grade motions  of  the  cefophagus  are  vifible  to  the  eye,  as  they 
bring  up  the  foftened  grafs  from  their  firi't  ftomach.  The  veg- 
etable aliment  in  the  firft  ftomach  of  cattle,  which  have  filled 
themfelves  too  full  of  young  clover,  is  liable  to  run  into  ferment- 
ation, and  diftend  the  ftomach,  fo  as  to  preclude  its  exit,  ari<j 
frequently  to  deftroy  the  animal.  To  difcharge  this  air  the 
farmers  frequently  make  an  opening  into  the  ftomach  of  the 
animal  with  fuccefs.  I  was  informed,  I  believe  by  the  late  Dr. 
Whytt  of  Edinburgh,  that  of  twenty  cows  in  this  fituation  two 
had  died,  and  that  he  directed  a  pint  of  gin  or  whiiky,  mixed 
with  an  equal  quantity  of  water,  to  be  given  to  the  other  eigh- 
teen j-all  of  which  erupted  immenfe  quantities  of  air,  and  recov- 
ered. 

There  are  hiftories  of  ruminating  men,  and  who  have  taken 
pleafure  in  the  act  of  chewing  their  food  a  fecond  time.  Phi- 
lof.  Tranfaa. 

2.  Ruclus.  Eructation.  An  inverted  motion  of  the  ftomach 
excluding  through  its  upper  valve  an  elaftic  vapour,  generated 
by  the  fermentation  of  the  aliment ;  which  proceeds  fo  haftily, 
that  the  digeitive  power  does  not  fubdue  it.  This  is  fometimes 
acquired  by  habit, fo  that  fome  people  can  eru6t  when  they  pleale, 
and  as  long  'as  they  pleafe ;  and  there  is  gas  enough  generated 
to  lupply  them  for  this  purpofe  ;  for  by  Dr.  Hales's  experiments, 
an  apple,  and  many  other  kinds  of  aliment,  give  up  above  fix 
hundred  times  their  own  bulk  of  an  eiaftic  gas  in  fermentation. 
When  people  voluntarily  eject  the  fixable  air  from  their  ftom- 
achs,  the  fermentation  of  the  aliment  proceeds  the  fafter  ;  for 
flopping  the  ve{fels3  which  contain  new  wines,  retards  their  fer- 

mentationj 


CLASS  I.  3.  i.  3.        OF   IRRITATION.  133 

1  opening  them  again  accelerates  it ;  hence  where 

thsdi;>e!'Uon  is  impaired,  and  the  ftomach  fomewhat  diftended 

with  air,  it  is  hetter  to  reftrain  than  to  encourage   eructations, 

^t  the  quantity  makes  it  necefiary.     When  wine  is  confined 

in  bottles,  the  fermentation  ftill  proceeds  flowly  even  for  years, 

till  all  the  fugar  is  converted  into  fpirit ;  but  in  the  procefs  oi 

i<  n,  the  faccharme  part  is  abforbed  in   the  form  of  chyle 

by"  the  bibulous  months' of  the  numerous  lafteals,  before  it  has 

time  to  run  into  the  vinous  fermentation. 

3.  Apepjia.     Indigeition.     Water-qualm.     A  few  mouthfuls 
of  the  aliment  are  rejected  at  a  time  for  fome  hours  after  meals. 
When  the  aliment  has  had  time  to  ferment,  and  become  acid,  it 
produces  cardialgia,  or  heart-burn.     This  difeafe  is  perhaps  gen- 
erally left  after  a  flight  inflammation  of  the  ftomach,  called  a  fur- 
feit,  ocoiifioned  by  drinking  cold  liquors,  or  eating  cold  vegeta- 
bles, when   heated   with   exercife.     This  inflammation  of  the 
ilomach  is  frequently,  I  believe,  at  its  commencement  removed 
by  a  critical  eruption  on  the  face,  which  differs  in  its  appearance 
as  well  as  in  its  caufe  from  the  gutta  rofea  of  drunkards,  as  the 
ikin  round  the  bale  of  each  eruption  is  lefs  inflamed.     See  Clafs 
II.    i.  4.  6.     This  difeafe  differs  from  Cardialgia,  Clafs  I.  2.  4. 
5.  in  its  being  not  uniformly  attended  with  pain  of  the  cardia 
ventriculi,  and  from  its  retrograde  motions  of  apart  of  the  ftom- 
ach about  the  upper  orifice  of  it.     In  the  fame  manner  as  hyfte- 
ria  differs  from  hypochondriaGs  ;  the  one  confiding  in  the  weak- 
nefs  and  indigeftion  of  the  fame  portions  of  the  alimentary  canal, 
and  the  'other  in  the^inverted  motions  of  fome  parts  of  it.     This 
apepfia  or  water-qilalm  continues  many  years,  even  to  old  age ; 
Mr.  G of  Litchfield  fuffered  under  this  difeafe  from  his  in- 
fancy ;  and,  as  he  grew  old,  found  relief  only  from  repeated  dofes 
of  opium. 

M.  M.     A  blifter,  rhubarb,  a  grain  of  opium  twice  a  day. 
Soap,  iron-powder.     Tin-powder. 

4.  Vomit  us.     An  inverted  order  of  the  motions  of  the*  flom- 
ach  and  cefophagus  with  their  abforbent  veifels,  by   which  their 
contents   are  evacuated.     In  the  act  of  vomiting  lefs  fenforial 
power  is  employed  than  in  the   ufual  periftaltic  motion  of  the 
ftomach,  as  explained  in  Seel.   XXXY.    i.   3.     Whence  after 
the  operation  of  an  emetic  the  digeftion  becomes  ftronger  by  an 
accumulation   of  fenforial   power  during  its   decreafed  aclion. 
This  decreafed  action  of  the  ftomach  may  be  either  induced  by 
want  of  ftimulus,  as  in  the  ficknefs  which  attends  hunger  ;  or  it 
may  be  induced  by  temporary  want  of  irritability,  as   in  cold  fits 
<?f  fever  •,  or  from  habitual  want  of  irritabilitv,  as  the  vomiting 

of 


134  DISEASES  CLASS  I.  3.  i. 


of  enfeebled  drunkards.     Or  laftly,  by  having  been  previoufly 
too  violently  ftimulated  by  an  emetic  drug,  as  by  ipecacuanha. 

M.  M.  Abliiler.  An  emetic.  Opium.  Warmth  of  a  bed, 
covering  the  face  for  a  while  with  the  bed-clothes.  Crude  mer- 
cury. A  poultice  with  opium  or  theriaca  externally. 

5.  Cholera.     When  not  only  the  ftomach,  as  in  the  laft  arti- 
cle, but  alfo  the  duodenum,  and  ileum,  as  low  as  the  valve  of  the 
colon,  have  their  motions  inverted  ;   and  great  quantities  of  bile 
are  thus  poured  into  the  ftomach  ;  while  at  the  fame  time  fome 
branches  of  the  lacleals  become  retrograde,  and   difgorge  their 
contents  into  the  upper  part  of  the  alimentary  canal  ;  and  other 
branches  of  them  difgorge  their  contents  into  the  lower  parts  of 
it  beneath  the  valve  of  the  colon  ;  a  vomiting  and  purging  com- 
mence together,  which  is  called  cholera,  as  it  is  fuppofed  to  have 
its  origin  from  increaied  fecretion  of  bile  ;  but  I  fuppofe  more 
frequently  arifes  from  putrid  food,  or  poifonous  drugs,  as  in  the 
cafe  narrated  in  Se<£r,.  XXV.   13.   where  other  circumftances  of 
this  difeafe  are  explained.     See  Clafs  II.    r.  2.    11. 

The  cramps  of  the  legs,  which  are  liable  to  attend  cholera, 
are  explained  in  Clafs  III.  i.  i.  15. 

6.  Ileus.  Confifts  in  the  inverted  motions  of  the  whole  intefti- 
nal  canal,  from  the  mouth  to  the  anus  ;  and  of  the  lacleals  and 
abforbents  which  arife  from  it.     In  this  pitiable  difeafe,  through 
the  valve  of  the  colon,  through  the  pylorus,  the  cardia,   an 
pharynx,  are  ejected,  firft,  the  contents  of  the  ftomach   ar: 
teftines,  with  the  excrement  and  even  clyfters  themfelves  j  t^ea 
the  fluid  from  the  lacleals,  which  is  now  poured  into  the  intef- 
tines  by  their  retrograde  motions,  is  thrown  up  by   the  mouth  ; 
and,  laftly,  every  fluid,  which  is  abforbed  by  the  other  lymphatic 
branches,  from  the  cellular  membrane,  the  fkin,  the  bladder,  and 
all  other  cavities  of  the  body  ;  and  which  is  then  poured    into 
the  ftomach  or  inteftines  by  the  retrograde  motions  of  the  lacle- 

.als;  all  which  fupply  that  amazing  quantity  of  ftttid,  which  is 
in  this  difeafe  continually  ejected  by  vomiting.  See  Seel:.  XXV. 
15.  for  a  further  explanation  of  this  difeafe. 

M.  M.  Copious  vene.fecHon.  Twenty  grains  of  calomel  in 
fmall  ptlisj  or  one  grain  of  aloe  every  hour  till  ftools  are  procur- 
ed. BlifterS.  Warm  bath.  Crude  mercury.  Clyfter  of  ice- 
water.  Smear  the  fkin  all  over  with  greafe,  as  mentioned  in 
Sea.  XXV.  15. 

As  this  malady  is  occafioned  fometimes  by  an  introfufception 
of  a  part  of  the  inteftine  into  another  part  of  it,  efpecially  in 
children,  could  holding  them  up  by  their  heels  for  a  fecond  or 
two  of  time  be  of  fervice  after  venefecl:ion  ?  Or  the  exhibition 
of  crude  quickfilver  two  ounces  every  half  hour,  till  a  pound  is 

taken, 


CLASS  I.  3.  i.  7-        OF  IRRITATION.  13; 

taken,  be  particularly  ferviceable  in  this  circUmftance  ?  Or 
could  half  a  pound,  or  a  pound,  of  crude  rrfercury  be  injected  as 
a  clyfter,  the  patient  being  elevated  by  the  knees  and  thighs  fo 
as  to  have  his  head  and  fhoulders  much  lower  than  his  bottom, 
or  even  for  a  fhort  time  held  up  by  the  heels  ?  Could  this  alfo 
be  of  advantage  in  ftrangulated  hernia  ? 

Where  there  exifts  an  introfufception  of  the  inteftine,  or  in 
obftinate  coitivenefs,  perhaps  a  forcing  pump,  fuch  as  gardeners 
employ  to  water  their  trees,  might  be  ufed  with  advantage,  by 
driving  water  forcibly  up  the  rectum,  as  is  mentioned  by  Mr. 
Ad  air ;  and  was  ufed  by  Dettaen  in  experiments  on  dogs,  who 
found  the  valve  of  the  colon  did  not  prevent  warm  water  being 
pulhed  along  the  whole  courfe  of  the  alimentary  canal  by  a 
forcing  fyringe.  This  is  well  worthy  trial,  as  well  as  the  quick- 
filver  introduced  by  the  anus  in  inflammations  of  the  inteftines, 
where  no  paflage  downwards  can  be  procured. 

Where  an  introfufception  of  the  inteftine  exifts,  as  is  believ- 
ed frequently  to  occur  in  thofe  inflammations  of  the  bowels  of 
children,  which  are  not  owing  to  fome  indigestible  material,  as 
to  plum  ftones  or  cherry  ftones,  it  is  probable  that  a  quantity  of 
air  alone,  or  of  the  fmoke  of  tobacco,  might  be  injected  fo  forci- 
bly as  to  dilate,  and  in  confequence  to  pals  the  valve  of  the  co- 
lon ;  and  might  pufh  into  its  place  the  flrang'ulated  duplicating  of 
the  inteftine.  Air  might  be  thus  injected  from  a  large  brown 
bladder  by  means  of  a  clyfter-pipe  covered  with  foft  leather 
moiftened  with  oil  or  mucilage,  or  by  means  of  bellows,  or  the 
common  apparatus  for  injecting  the  fmoke  of  tobacco,  or  by  a 
fyringe  ufed  for  condenfmg  air  in  philofophical  experiments.  I 
have  feen  fchool-boys  blow  air  through  a  grafs-ftem into  the  bow- 
els of  frogs,  fo  as  to  prevent  their  diving,  without  injuring  them. 

Where  the  difeafe  is  owing  to  ftrangulated  hernia,  the  part 
fliould  be  fprinkled  with  cold  water,  or  iced  water,  or  fait  and 
water  recently  mixed,  or  moiftened  with  ether.  In  cafes  of 
ftrangulated  hernia,  could  a  cupuncture,  or  puncture  with  a  ca- 
pillary trocar,  be  ufed  with  fafety  and  advantage  to  give  exit  to 
air  contained  in  the  ftrangulated  bowel  ?  Or  to  ftimulate  it  in- 
to action  ?  It  is  not  uncommon  for  bafhful  men  to  concent 
their  being  afflicted  with  a  fmall  hernia,  which  is  the  caufe  of 
their  death ;  this  circumftance  fhould  therefore  always  be  in- 
quired into.  Is  the  feat  or  caufe  of  the  ileus  always  below  the 
valve  of  the  colon,  and  that  of  the  cholera  above  it  ?  See  Clafs 

II.     I.    2.     II. 

7.   Globus  hyftericus.     Hyfteric  fuffocation    is  the  perception 
of  a  globe  rolling  round  in  the   abdomen,  and  afcending  to  the 
ftomach  and  throat,  and  there  inducing  ftrangulation.     It  con- 
fids 


DISEASES  CLASS  I.  3.  i.  1 

Cfts  of  an  ineffe&ual  inverfion  of  the  motions  of  the  cefophaguS, 
and  other  parts  of  the  alimentary  canal ;  nothing  being  rejected 
from  the  liomach. 

M.  M.  Tincture  of  caftcr,  tinct.  of  opium,  of  each  1 5  drops. 
See  Hyfteria,  Clafs  I.  3.  i.  9. 

8.  Vomendi    conamen  inane.     An  ineffectual  effort  to  vomit. 
It  frequently  occurs,  when   the  ftomach  is  empty,  and  in  fome 
cafes  continues  many  hours-,  but  as  the  lymphatics  of  the  ftom- 
ach are  not  inverted  at  the  fame  time,  there  is  no  fupply  of  mate- 
rials to  be  ejected  \  it  is  fometimes  a  fymptom  of  hyttena,  but 
more  frequently  attends  irregular  epilepfies  or  reveries  ;   which 
however  may  be  diftinguimed  by  their  violence  of  exertion,  for 
the  exertions  of  hyfteric  motions   are  feeble,  as  they  are  caufed 
by  debility  ;  but  thofe  of  epileptics,  as  they  are  uted  to  relieve 
pain,  are  of  the  mod  violent  kind  ;  infomuch  that  thofe  who 
have  once  feen  thefe  ineffectual  efforts  to  vomit  in  fome  epilep- 
fies, can   never  again  miftake  them  for  fymptoms  of  hyftetia. 
See  a  cafe  in  Sett.  XIX.  2. 

M.  M.  Biiiter.     Opium.     Crude  mercury. 

9.  Borborigmus.     A  gurgling   of  the  bowels  proceeds  from  a 
partial  invertion  of  the  periitaltic  motions  of  them,  by  which  the 
gas  is  brought  into   a  fuperior  part  of  the  bowel,   and  bubbles 
through  the  defcending  fluid,  like  air  rufhing  into  a  bottle  as  the 
water  is  poured  oat  of  it.     Thr*  is  fometimes  a  diitreffing  fymp- 
tom of  the  debility  of  the  bowels  joined  with  a  partial  inverfion 
of  their  motions.     I  attended  a  young  lady  about  fixteen,  who 
\vas   in  other    fefpects  feeble,   whofe  bowels  almoft  inceffantly 
made  a  gurgling  noife  fo  loud  as   to  be  heard  at  a  confiderable 
diflance,  and  to  attract  the  notice  of  all  who  were  near  her.     As 
this  noife  never  ceafed  a  minute  together  for  many  hours  in  a  day, 
it  could  not  be  produced  by  the   uniform  deicent  of  water,  and 
afcent  of  air  ihro'ugh  it,  but  there  muit  have  been  alternately  a 
retrograde  movement  of  a   part  of  the  bowel,  which  mud  again 
have  pufhed  up  the   water  above  the  air  ;  or  which  might  raife 
a  part  of  the  bowel,  in   which  the  fluid  was  lodged,  alternately 
above  and  below  another  portion  of  it ;  which  might  readily  hap- 
pen in  fome  of  the  curvatures   of  the  fmaller  inteftiries,  the  air 
in  which   might   be  moved  backward  and  forward  like  the  air- 
bubble  in  a  glafs-level. 

M.  M.  Eilential  oil.  Ten  corns  of  black  pepper  fwallowed 
whole  after  dinner,  that  its  effect  might  be  flower  and  more  per- 
manent \  a  fmall  pipe  occafionally  introduced  into  the  rectum 
to  facilitate  the  cfcape  of  the  air.  Crude  mercury.  See  Clafs  I. 
2.  4.  8. 

10.  Helena.     The  three  b&  articles,  together  with  the  lv 

phatic 


CLASS  I.  3.  t- 10.       OF  IRRITATION.  137 

phatic  diabetes,  are  the  moft  common  fymptoms  of  the  hyfteric 
difeafe ;  to  which  fometimes  is  added  the  lymphatic  falivation, 
and  fits  of  fyncope,  or  convulfion,  with  palpitation  of  the  heart 
(which  probably  confifts  of  retrograde  motions  of  it),  and  a  great 
fear  of  dying.  Which  laft  circumftance  diftinguiihes  thefe  con. 
vulfions  from  the  epileptic  ones  with  greater  certainty  than  any 
other  fmgle  fymptom.  The  pale  copious  urine,  cold  ikin,  palpi- 
tation, and  trembling,  are  the  fymptoms  excited  by  great  fear. 
Hence  in  hyfteric  difeafes,  when  thefe  fymptoms  occur,  the  fear, 
which  has  been  ufually  aflbciated  with  them,  recurs  at  the  fame 
time,  as  in  hypochondriaiis,  Clafs  I.  2.  4.  10.  See  Sect.  XVI. 
8.  i. 

The  convulfions  which  fometimes  attend  the  hyfteric  difeafe, 
are  exertions  to  relieve  pain,  either  of  fome  torpid,  or  of  fome 
retrograde  organ  •,  and  in  this  refpect  they  refemble  epileptic 
convulfions,  except  that  they  are  feldom  ib  violent  as  entirely  to 
produce  infenfibility  to  external  ftimuli ;  for  thefe  weaker  pains 
ceafe  before  the  total  exhauftion  of  fenforial  power  is  produced, 
and  the  patient  finks  into  imperfect  fyncope  ;  whereas  the  true 
epilepfy  generally  terminates  in  temporary  apoplexy,  with  per- 
fect infenfibility  to  external  objects.  Thefe  convulfions  are  lets 
to  be  dreaded  than  the  epileptic  ones,  as  they  do  not  originate 
from  fo  permanent  a  caufe. 

The  great  difcharge  of  pale  urine  in  this  difeafe  is  owing  to 
the  inverted  motions  of  the  lymphatics,  which  arife  about  the 
neck  of  the  bladder,  as  defcribed  in  Sect.  XXIX.  4.  5.  And 
the  lymphatic  falivation  arifes  from  the  inverted  motions  of  the 
falivary  lymphatics. 

Hyfteria  is  diftinguifhed  from  hypochondriaiis,  as  in  the  latter 
there  are  no  retrograde  motions  of  the  alimentary  canal,  but  lim- 
ply a  debility  or  inirritability  of  it,  with  diftendon  and  flatulency. 
It  is  diftinguifhed  from  apepfia  and  cardialgia  by  there  being  noth- 
ing ejected  from  the  ftomach  by  the  retrograde  motions  of  it, 
or  of  the  cefophagus. 

M.  M.  Opium.  Camphor.  Aiafcetida.  Caftor,  with  fin- 
apifms  externally  ;  to  which  muft  be  added  a  clyfter  of  cold  wa- 
ter, or  iced  water  ;  which,  according  to  Monf.  Pomme,  relieves 
thefe  hyfteric  fymptoms  inftantaneoufly  like  a  charm  -,  which  it 
may  effect  by  checking  the  inverted  motions  of  the  inteftinal  ca- 
nal by  the  torpor  occafioned  by  cold  j  or  one  end  of  the  intefti- 
nal canal  may  become  ftrengthqned,  and  regain  its  periftaltic 
motion  by  reverfe  fympathy,  when  the  other  end  is  rendered 
torpid  by  ice-water.  (Pomme  des  Affections  Vaporeufes,  p.  25.) 
Thefe  remove  the  prefent  fymptoms  j  and  bark,  fteel,  exercife, 
coldifh  bath,  prevent  their  returns.  See  Art.  VI.  2.  i . 

VOL.  II.  T  ii.  Hydnpkobia. 


13,8  DISEASES  CLASS  1. 3.  r*  Hi 

II.  Hydrophobia.  Dread  of  water  occafioned  by  the  bite  of  a 
mad-dog,  is  a  violent  inverfion  of  the  motions  of  the  cefopha- 
gus  on  the  contact  or  even  approach  of  water  or  other  fluids. 
The  pharynx  feems  to  have  acquired  the  fenfibility  of  the  larynx 
in  this  difeafe,  and  is  as  impatient  to  reject  any  fluid  which  gets 
into  it.  Is  not  the  cardia  ventriculi  the  feat  of  this  difeafe  ?  As 
in  cardialgia  the  pain  is  often  felt  in  the  pharynx,  when  the  acid 
material  ftimulates  the  other  end  of  the  canal,  which  terminates 
in  the  ftomach.  As  this  fatal  difeafe  refembles  tetanus,  or  lock- 
ed jaw,  in  its  tendency  to  convulfion  from  a  diftant  wound,  and 
affects  fome  other  parts  by  afibciation,  it  is  treated  of  in  Clafs 
III.  i.  i.  15.  andlV.  2.  i.  7. 

M.  M.  I  fhould  recommend  the  trial  of  one  grain  and  a  half 
of  corrofive  fublimate  of  mercury,  hydrargyrus  muriatus,  dif- 
folved  in  half  an  ounce  of  rectified  fpirit  of  wine,  to  be  given 
undiluted,  if  poflible,  as  defcribed  in  Clafs  II.  i.  5.  I.  and  to  be 
repeated  according  to  its  operation. 


ORDO 


i  I.  3.  -.  i.      OF  IRRITATION.  13$ 

ORDO  III. 

^Retrograde  Irritative  Motions, 

GENUS  II. 

Of  the  Abforbent  Syjlem. 

SPECIES. 

1 .  Catarrhus  lymphaticus.  Lymphatic  catarrh.  A  periodic- 
al defluxion  of  a  thin  fluid  from  the  noftrils,  for  a  few  hours, 
occafioned  by  the  retrograde  motions  of  their  lymphatics  ;  which 
may  probably  be  fupplied  with  fluid  by  the  increafed  abforption 
of  fome  other  lymphatic  branches  in  their  vicinity.  It  is  dif- 
tinguifhed  from  that  mucous  difcharge,  which  happens  in  frofty 
weather  from  decreafed  abforption,  becaufe  it  is  lefs  fait  to  the 
tafte ;  and  from  an  increafed  fecretion  of  mucus,  becaufe  it  is 
neither  fo  vifcid,  nor  is  attended  v/kh  heat  of  the  part.  This 
complaint  is  liable  to  recur  at  diurnal  periods,  like  an  intermit- 
tent fever,  for  weeks  and  months  together,  with  great  fneezing 
and  very  copious  difcharge  for  an  hour  or  two. 

I  have  feen  two  of  thefe  cafes,  both  of  which  occurred  in  deli- 
cate women,  and  feemed  an  appendage  to  other  hyfteric  fymp- 
toms  ;  whence  I  concluded,  that  the  difcharge  was  occafioned  by 
the  inverted  motions  of  the  lymphatics  of  the  noilrils,  like  the 
pale  urine  in  hyfteric  cafes  ;  and  that  they  might  receive  this 
fluid  from  fome  other  branches  of  lymphatic  veflels  opening  into 
the  frontal  or  maxillary  cavities  in  their  vicinity. 

Could  fuch  a  difcharge  be  produced  by  ftrong  errhines,  and 
excite  an  abforption  of  the  congeftion  of  lymph  in  the  dropfy  of 
the  brain  ? 

2.  Sa/ivatio  lymphatica.     Lymphatic  falivation.      A   copious 
expuition  of  a  pellucid  infipid  fluid,  occafioned  by  the  retrograde 
motions  of  the  lymphatics  of  the  mouth.     It  is  fometimes  peri- 
odical, and  often  attends  the  hyfteric  difeafe,  and  nervous  fevers ; 
but  is  not  accompanied  with  a  faline  tafte,  or  with  heat  of  the 
mouth,  or  naufea. 

3.  Naufea   humida.     Moid   naufea  confifts  in    a  difcharge  of 
fluid,  owing  to  the  retrograde  motions  of  the  lymphatics  about 
the  fauces,  without  increafe  of  heat,  or    faline  tafte,  together 
with  fome  retrograde  motions  of  the   fauces  or  pharynx    along 
with  this  naufea,  a  ficknefs  generally  precedes  the  act  of  vomit- 
ing ;  which  may  confift  of  a  fnnilar  difcharge  of  mucus  or  chyte 

int* 


i4®  DISEASES  CLASS  1, 3. 2. 4. 

into  the  ftomach  by  the  retrograde  motions  of  the  lymphatics  or 
ladteals,  which  open  into  it.     See  Clafs  I.  2.  4.  3.  and  I.  2.  4.  4. 
M.  M.     Subacid  liquids.     Wine.     Opium.     A  blifler. 

4.  Diarrhoea  lymphatica.     Lymphatic  diarrhoea.     A  quantity 
of  mucus    and  lymph  are  poured  into  the  inteftines  by  the  in- 
verted motions  of  the  inteftinal  lymphatics.     The  feces  are  lefs 
fetid  and  more  liquid  ;  and  it  fometimes  portends  the  commence-* 
rnent  of  a  diabetes,  or  dropfy,  or  their  temporary  relief.     This 
lymphatic  diarrhoea  fometimes  becomes  chronical,  in  which  the 
atmofpheric  moiflure,  abforbed  by  the  cutaneous  and  pulmona- 
ry lymphatics,  is  poured  into  the  inteftines  by  the  retrograde  mo- 
tions of  the  lafteals.     See  Section  XXIX.  4.  6.  where  fome 
cafes  of  this  kind  are  related. 

5.  Dmrrbcc.a  chylifera,  cxtiaca.     Chyliferous  diarrhoea.     The 
chyle  drank  up  by  the  lacleals  of  the  upper  inteftines  is  poured 
into  the  lower  ones  by  the  retrograde  motions  of  their  lafteals, 
and  appears  in  the  dejections.     This  circtmftance  occurs  at  the 
beginning  of  diarrhoea  crapulofa,   where  the  patient  has  taken 
and  digefted  more  aliment  than  the  fyftern  can  conveniently  re- 
ceive, and  thus  eliminates  a  part  of  it ;  as  appears  when  there  is 
curdled  chyle  in  fome  of  the  dejections.    SeeSeft.  XXIX.  4.  7, 
It  differs  from  the  lymphatic  diarrhoea,  as  the  chyliferous  diabe- 
tes differs  from  the  aqueous  and  mucaginous  diabetes. 

6.  Diabetes.  By  the   retrograde  motions  of  the   urinary   lym-. 
phatics,  an  immenfe  quantity  of  fluid  is  poured  into  the  bladder. 
It  is  either  termed  chyliferous,  or  aqueous,  or  mucaginous,  from 
the  nature  of  the  fluid  brought  into  the  bladder  ;  and  is  either  a 
temporary  difeafe,  as  in  hyfteric  women,  in  the  beginning  of  in- 
toxication, in  worm  cafes,  or  in  thofe  expofed  to  cold  damp  air, 
or  to  great  fear,  or  anxiety,  or  in  the  commencement  of  fome 
dropfies  ;  or  it  becomes  chronical. 

When  the  urinary  lymphatics  invert  their  motions,  and  pour 
their  refluent  contents  into  the  bladder,  fome  other  branch  o£ 
the  abforbent  fyftem  a£ts  with  greater  energy  to  fupply  this  flu- 
id. If  it  is  the  inteftinal  branch,  the  chyliferous  diabetes  is  pro- 
duced :  if  it  is  the  cutaneous  or  pulmonary  branch,  the  aqueous 
diabetes  is  produced  :  and  if  the  cellular  or  cyftic  branches,  the 
mucaginous  diabetes.  In  the  two  laft  the  urine  is  pellucid,  and 
contains  no  fugar. 

In  dropfies  the  fluid  is  fometimes  abforbed,  and  poured  into 
the  bladder  by  the  retrograde  motions  of  the  urinary  lymphatics, 
as  during  the  exhibition  of  digitalis.  In  the  beginning  of  the 
dropfies  of  infirm  gouty  patients,  I  have  frequently  obferved, 
that  they  make  a  large  quantity  of  water  for  one  night,  which 
relieves  them  for  feveral  days.  In  thefe  cafes  the  patient  prcvi- 

oufly 

I 


CLASS  I.  3  OF  IRRITATION.  141 

[y  feels  a  fulnefs  about  the  prrecordia,  \vith  difficult  refpira- 
I,  and  fymptoms  fimilar  to  thofe  ofhyfteria.     Perhaps  a  pre- 
vious defect  of  abforption  takes  place  in  ibme  part  of  the  body  in 
thofe  hyfteric  cafes,  which  are  relieved  by  a  copious  difcharge  of 
pale  urine.  See  Diabetes  explained  at  large,  Section  XXIX.  4. 

A  difcharge  of  blood  fometimes  attends  the  diabetes,  which 
was  occafionally  a  fymptom  of  that  difeafe  in  Mr.  Brindley,  the 
great  navigable  canal  maker  in  this  country.  Which  may  be 
accounted  for  by  the  communication  of  a  lymphatic  branch  with 
the  gaftric  branch  of  the  vena  portarum,  as  difcovered  by  J.  F. 
Meckel.  See  Section  XXVII.  2. 

M.  M.  Alum.  Earth  of  alum.  Cantharides.  Calomel. 
Bark.  Steel.  Refin.  Opium.  Seq  Sett.  XXIX.  4. 

Since  the  publication  of  the  firft  edition  of  this  work,  I  have 
feen  two  patients  affefted  with  diabetes,  who  were  both  of  them 
between  fixty  and  feventy  years  old,  and  had  formerly  lived  rath- 
er freely,  though  very  temperately  latterly  for  many  years.  The 
water  they  made  had  not  been  accurately  meafured  or  evapora- 
ted ;  but  one  of  them  obferved  that  his  terrier  bitch  lapped  his 
urine  in  large  quantities, and  preferred  it  much  to  common  water; 
whence  he  concluded,  it  muft  contain  fome  nutritious  matter. 

They  both  complained  of  thirft,  and  had  drunk  two  or  three 
times  as  much  as  ufual,  during  the  time  they  had  been  affected 
with  the  diabetes  ;  which  was  about  four  months  in  one,  and 
about  three  in  the  other.  As  I  efteemed  thefe  cafes  to  be  ow- 
ing to  the  patients  fwallowing  more  fluid  than  could  be  fo  hafti- 
ly  taken  into  the  circulation,  and  that  therefore  a  part  of  it  was 
conveyed  to  the  bladder  by  the  retrograde  action  of  the  lymphat- 
ics, as  in  the  beginning  of  intoxication  ;  I  prevailed  on  them  to 
drink  no  more  than  their  ufual  quantity,  or  lefs ;  and  both  thefe 
mild  cafes  of  diabetes  ceafed  immediately  by  this  fimple  treat- 
ment of  them. 

A  (imilar  event  fe^ms  to  have  exifted  in  the  two  cafes  of  dia- 
betes firlt  published  by  Dr.  Rollo ;  on  thofe  days  the  patients 
drank  but  little,  the  quantity  of  urine  was  not  more  than  natural. 
Both  from  thefe  cafes,  and  from  others  related  by  Dr.  Rollo,  it 
appears,  that  when  the  patient  lived  on  Animal  food,  lefs  faccha- 
rine  matter  was  detected  in  the  urine,  and  alfo  that  the  quanti- 
ty of  the  urine  abated  j  the  former  of  thefe  circumftances  is  read- 
ily accounted  for,  as  vegetable  materials  are  probably  more  co- 
pioufly  convertible  into  fugar,  either  chemically  or  by  the  power 
of  digeftion,  than  animal  materials  ;  and  the  latter  feems  proba- 
bly owing  to  the  patients  drinking  lefs  in  quantity,  when  they 
were  retrained  from  beer  and  milk,  and  were  allowed  only  broth 
in  their  (K 

In 


*42  DISEASES  CLASS  I.  3.  2.  7; 

In  the  .cafe  from  Liverpool,  publifhed  by  Dr.  Rollo,  the  pa- 
tient did  not  weigh  heavier  after  fitting  ten  minutes  in  a  bath 
of  i  io  degrees  of  heat ;  which  fhews  that  no  part  of  the  diabe- 
tic urine  was  owing  to  increafed  cutaneous  abforption,  and  that 
this  difeafe  was  not  the  aqueous  but  the  chyliferous  diabetes ; 
and  I  fuppofe  the  patient's  weighing  heavier  or  not  after  ufmg 
a  warm  bath  may  depend  on  the  quantity  of  fluid  previoufly 
taken  by  the  mowrh  ;  as  the  ikin  may  thence  be  either  in  an  ab- 
forbent  or  exhalent  (late,  and  owing  to  a  greater  or  lefs  degree 
of  heat,  which  may  render  the  quantity  of  perfpiration  in  the 
bath  greater  than  the  quantity  abforbed.  See  Seel.  XXIX.  4.  5. 

7.  Sttdor  lymphaticus.  Profufe  fweats  from  the  inverted  mo- 
tions of  the  cutaneous  lymphatics,  as  in  fome  fainting  fits,  and 
at  the  approach  of  death  •,  and  as  perhaps  in  the  fudor  anglica- 
nus.  See  Seel:.  XXIX.  5.  Thefe  fweats  are  glutinous  to  the 
touch,  and  without  increafed  heat  of  theftdn  ;  if  the  part  is  not 
covered,  the  Ikin  becomes  cold  from  the  evaporation  of  the  fluid. 
Thefe  fweats  without  heat  fometimes  occur  in  the  act  of  vomit- 
ing, as  in  Seel:.  XXV.  9.  and  are  probably  the  caufe  of  the  cold 
fweaty  hands  of  fome  people.  As  mentioned  in  Seel.  XXIX. 
4.  9.  in  the  cafe  of  R.  Davis,  which  he  cured  by  frequent  ap- 
plication of  lime.  Though  it  is  poflible,  that  cold  fweaty  hands 
may  alfo  arife  from  the  want  of  due  abforption  of  the  perfpirable 
matter  effufed  on  them,  and  that  the  coldnefs  may  be  owing  to 
the  greater  evaporation  in  confequence. 

The  acid  fweats  defcribed  by  Dr.  Dobfon,  which  he  obferved 
in  a  diabetic  patient,  and  afcribes  to  the  chyle  effufed  on  the 
{kin,  mull  be  afcribed  to  the  retrograde  action  of  the  cutaneous 
lymphatics.  See  Sea.  XXIX.  6. 

'  8.  Sudor  afthmaticus.  The  cold  fweats  in  this  difeafe  only 
cover  the  head,  arms,  and  breaft,  and  are  frequently  exceeding- 
ly profufe.  Thefe  fweats  are  owing  to  the  inverted  motions  of 
the  cutaneous  lymphatics  of  the  upper  part  of  the  body,  and  at 
the  fome  time  the  increafed  abforption  of  the  pulmonary  abfor- 
bents  :  hence  thefe  fweats  when  profufe  relieve  the  prefent  fit  of 
afthma.  There  is  no  other  way  to  account  for  fweats  appear- 
ing on  the  upper  parts  of  the  body  only,  but  by  the  fluid  having 
been  abforbed  by  the  lymphatic  branch  of  the  lungs,  and  effufed 
on  the  fkin  by  the  retrograde  movements  of  the  cutaneous  lym- 
phatics ;  which  join  tliofe  of  the  lungs  before  they  enter  into 
the  venous  circulation.  For  if  they  were  occafioned,  as  gener- 
ally fuppofed,  by  the  difficulty  of  the  circulation  of  the  blood 
through  the  lungs,  the  whole  fkin  muft  be  equally  affected,  both 
of  the  upper  and  lower  parts  of  the  body  j  for  whatever  could 
obftruct  the  circulation  in  the  upper  part  of  the  venous  fyftem, 

muft 


CLASS  I.  3.  2.  9.        OF  IRRITATION.  143 

muft  equally  obftruct  it  in  the  lower  part  of  it.  See  Sect.  XXIX. 
6.  In  the  convulfive  afthma  thefe  fweats  do  not  occur  ;  hence 
they  may  be  diftinguifhed  ;  .  and  might  be  called  the  hydropic 
•afthma,  and  the  epileptic  afthma. 

9.  'Tranjlatw  puns.  Tranflation  of  matter  from  one  part  o£ 
the  fyftem  to  another  can  only  be  explained  from  its  being  ab- 
forbed  by  one  branch  of  the  lymphatic  fyftem,  and  depofited  in 
a  diftant  part  by  the  retrograde  motions  of  another  branch  ;  as 
mentioned  Sect.  XXIX.  7.  i.  It  is  curious,  that  thefe  tranfla- 
tions  of -matter  are  attended  generally,  I  believe,  with  cold  fits  ; 
for  lefs  heat  is  produced  during  the  retrograde  action  of  this 
part  of  the  fyftem,  as  no  fecretion  in  the  lymphatic  glands  of  the 
affected  branches  can  exift  at  the  fame  time.  Do  any  ineffec- 
tual retrograde  motions  occafion  the  cold  fits  of  agues  ?  The 
time  when  the  gout  of  the  liver  ceafes,  and  the  gout  in  the  foot 
commences,  is  attended  with  a  cold  fit,  as  I  have  obferved  in  two 
inftances,  which  is  difficult  to  explain,  without  fuppofing  the 
new  veflels,  or  the  matter  produced  on  the  inflamed  liver,  to  be 
abforbed,  and  either  eliminated  by  fome  retrograde  motion,  or 
carried  to  the  newly  inflamed  part  ?  See  Glafs  IV.  i.  2.  15. 

10.  Tranjlatio  laElis.     Tranflation  of  milk  to  the  bowels  irt 
puerperal  fevers  can  only  be  explained  by  the  milk  being  abforb- 
ed   by   the  pectoral  branch  of  lymphatics,  and  carried  to  the 
bowels  by  the  retrograde  motions  of  the  inteftinal  lymphatics  or 
lacleals.     See  many  inftances  of  this  in  Seel.  XXIX.  7.  4. 

1 1.  Tranjlatw  urinx.     Tranflation  of  urine.     There  is  a  curi- 
ous cafe  related  in  the  Tranfaclions  of  the  College  of  Phyficians 
at  Philadelphia,  Vol.  I.  p.  96.  of  a  girl,  who  labouring  under  an 
ifchuria  vomited  her  urine  for  many  months ;  which  could  not 
be  diftinguifhed  from  that  which  was  at  other  times  drawn  off 
by  the  catheter.     After  having  taken  much  opium,  (he  feemsat 
length  to  have  formed  gravel,   fome  of  which   was  frequently- 
brought  up  by  vomiting.     Dr.  Senter  afcribes  this  to  the  retro- 
grade motions  of  the  lymphatics  of  the  ftomach,  and  the  increaf- 
cd  ones  of  thofe  of  the   bladder,  and  refers  to  thofe  of  Sect. 
XXIX.  of  this  work  ;  which  fection  was  firft  publifhed  in  1780; 
and  to  Macquer's  Dictionary  of  Chemiftry,  Art.  Urine. 

The  patient  above  defcribed  fometimes  had  a  difcharge  of 
urine  by  the  navel,  and  at  other  times  by  the  rectum,  and  fome- 
times by  urinous  fweats. 


ORDO 


144  DISEASES  CLASS  I.  3.  3.  r. 

ORDO  III. 

Retrograde  Irritative  Motions* 

GENUS  III. 

Of  the  Sanguiferous  Syjtem, 

SPECIES. 

I.  Capillanum  mctus  retrogreffus*  In  micrbfcopicr  experi- 
ments it  is  ufual  to  fee  gfobules  of  blood  regurgitate  from  the  ca- 
pillary veflels  again  and  again,  before  they  pafs  through  them  9 
and  not  only  the  mouths  of  the  veins,  which  arife  from  thefc  ca- 
pillaries, are  frequently  feen  by  microfcopes  to  regurgitate  fome 
particles  of  blood  during  the  ftruggles  of  the  animal ;  but  a  re- 
trograde motion  of  the  blood  in  the  veins  of  thefe  animals,  from 
the  very  heart  to  the  extremities  of  the  limbs,  is  obfervable  by 
Intervals  during  the  diftrefles  of  the  dying  creature.  Haller, 
Elem.  Phyf.  T.  i.  p.  216.  See  Sedion  XXIX.  3.  8. 

2.  Palpitatio  cordis.     May  not  the  ineffectual  and  weak  une- 
qual motions  of  the  heart  in  hyfteric  cafes  be  afcribed  to  the  re- 
trograde motions  of  it,  which  continue  for  a  fliort  time,  or  ter- 
minate in  fyncope  ?  See  Clafs  IV.  3.  i.  6. 

3.  Anhelatwfpafmodica.    In  fome  afthmas  may  not  the  difficul- 
ty of  refpiration  arife  from  the  inverted  action  of  the  finer  branch- 
es of  the  bronchia,  or  of  the  pulmonary  artery  or  vein,  like  thofc 
of  the  capillaries  above  defcribed  in  No.  i.  of  this  genus  ? 


CLASS  It  i.  i.  DISEASES,  &c.  145 

"the  Orders  and  Genera  of  the  Second  Clafs  of  Difeafes* 
CLASS     II. 

DISEASES    OF    SENSATION. 

ORDO  I. 

lucreafed  Senfation. 

GENERA. 

1.  With  increafed  action  of  the  mufcles. 

2.  With  the  production  of  new  veffels  by  internal  membranes 

or  glands  with  fever. 

3.  With  the  production  of  new  veflels  by  external  membranes 

or  glands  with  fever. 

4.  With  the  produdion  of  new  veiTels  by  internal  membranes 

or  glands  without  fever. 

5.  With  the  production  of  new  vefiels  by  external  membranes 

or  glands  without  fever. 

6.  With  fever  confequent  to  the  produ&ion  of  new  veflels  or 

fluids. 

7.  With  increafed  adions  of  the  organs  of  fenfe. 

ORDO  II.     , 

Decreafed  Senfation. 
GENERA. 

1.  With  decreafed  actions  of  the  general  fyftem. 

2.  With  decreafed  actions  of  particular  organs. 

ORDO  III. 

Retrograde  Senfitive  Motions. 

GENERA. 

1.  Of  the  arterial  fyftem. 

2.  Of  the  abforbent  fyftem. 

3.  Of  the  excretofjr  duels. 


VOL.  II. 


DISEASES  CLASS  II.  i.  i* 

The  Orders,  Genera,  and  Species,  of  the  Second  Clafs  of 


CLASS    II. 

DISEASES   OF    SENSATION, 

ORDO  r. 

Increafed  Senfation. 

GENUS  I.  j 

With  Increafed  Aftion  of  the  mufcles, 
SPECIES. 

1.  Deglutitio.  Deglutition. 

2.  Refpiratio.  Refpiration. 

3.  Sternutatio.  Sneezing. 

4.  Anhelitus.  Panting. 

5.  Tujffts  ebriorum.  Cough  of  inebriates. 

6.  Singuttuf.  Hiccough. 

7.  Crapula  ventriculi.  Indigeftion. 

8.  AJlhma  humorale.  Humoral  aflhma. 

9.  Ni&itatio-fetjptiva.  Winking  from  pain. 

I  o.   Ofcitatio  et  pandiculatio*  Yawning  and  ftretchinga 

1 1 .  Tenefmus.  Tenefmus. 

12.  Stranguria.  Strangury. 

13.  Parturitio.  Parturition. 

GENUS  II. 

With  the  ProduElion  of  new  Feffels   by  internal  Membranes  or 
Glands,  with  Fever. 

SPECIES. 

1.  Febris  fen/itiva  irritata.  Senfitive  irritated  fever. 

2.  Ophthalmia  internet.  Inflammation  of  the  eye. 

3.  Phrenitis. of  the  brain. 

4.  Peripneumonia.  . — , of  the  lungs. 

trachealis.  The  croup. 

5.  Pleuritis.  Inflammation  of  the  pleura. 

6.  Diaphragmitis.  of  the  diaphragm. 

7.  Carditis.  ^- —  of  the  heart. 

8.  Peritonitis.  , of  the  peritone- 

um. 

9.  Mefenteritis^  of  the  mefentery- 

IO.  Gajlritis, 


CLASS  II.  1.3- 


OF  SENSATION. 


10.  Gaftritis. 

1 1 .  Enteritis. 

1 2.  Hepatitis.  ' 

1 3 .  Sp/enitis. 
li\.  Nephritis* 

15.  CyJIitis. 

16.  Hyfleritis. 

17.  Lumbago  fenfttiva. 

1 8.  7/27^/. 

j  9.  Paronychia  internet* 


Inflammation  of  the  flomach. 
of  the  bowels, 
of  the  liver, 
of  the  fpleen. 
of  the  kidney, 
of  the  bladder, 
of  the  womb, 
of  the  loins. 
of  the  pelvis, 
beneath  the  nails. 


GENUS  III. 

With  the  Produftion  of  new  Vcjjels  by  external  Membranes  or 
Glands,  with  Fever. 

SPECIES. 

Senfitive  inirritated  fever, 
Eryfipelas,  irritated. 

. inirritated. 

., fenfitive.        ^ 


I.  Febris  fenfitiva  inirritata. 
1.  Eryfipelas  irritatum. 

inirritatum. 

•fenfitivum. 


3-   Tonfillitis  interna. 

, —  fuperficialis. 

inirritata* 

4.  Parotitis  fuppitrans. 

. mutabilis. 

felina. 

Catarrhus  fenfitivus. 

contagiofus. 

— equinus  ei  cani- 

nus. 

Peripneumonia  fuperficialjs. 

Pertujjis. 

Variola  difcreta. 

confluens. 

• inoculata. 

Rubeola  irritata. 

•  inirritata. 

1 1 .  Scarlatina  mitis. 
maligna. 

1 2 .  Miliaria  fudatoria. 

•  irritata. 
" •  inirritata. 

13.  Pejlis. 
vaccina. 

14.  Pemphigus. 


6. 


10. 


Angina,  internal. 

fuperficial. 

i inirritated. 

Mumps,  fuppurative. 

. mutable. 

. of  cats. 

Catarrh,  inflammatory. 

• contagious. 

among  horfes  and  dogs. 

Superficial  peripneumony. 
Chin-cough. 
Small-pox,  diftincl:. 

• confluent. 

inoculated. 

Meafles,  irritated. 
-  inirritated. 

Scarlet  fever,  mild. 

• malignant. 

Miliary  fever,  fudatory. 

"     .        irritated. 

inirritated. 

Plague. 

of  horned  cattle. 

Bladdery  fever. 

15.  Varicellr 


DISEASES 


CLASS  II.  i.  4. 


l£.   Varicella. 

1 6.  Urticaria. 

17.  Aphtha  fenfitiva. 

—  irritata. 

inirritata. 

1 8.  Dyfenteria. 

1 9 .  Gaftriiis  fuperfaialis. 

2  o .  Enteritis fupe rficialis. 


Chicken-pox. 
Nettle-raih. 
ThruiTi,  fenfitive. 
; — — —  irritated. 

imrritatejl. 

Bloody  flux. 
Superficial  inflam.  of  the  ftom- 
acli. 

ofthebowelsc 


GENUS  IV. 

With  the  Production    of  New   Vejjels   by    internal  Metnbranes  or 
Glandsy  •without  Fever. 

SPECIES. 


Ophthalmia  fuperfcialis. 
--  lymphatica. 


Ptengion. 

Tarfitis  pal  pebr  arum. 

Hordeolum. 

Pa  romch'ia  fuperfclalis  . 

6.  Gutta  rofea  hepatica. 
—  —  -  fomatica. 
--  hereditaria. 

7.  Odontitis. 

8.  Otitis. 

9.  Fiftula  iacrymalis. 
I  p.  Fijlula  in  ano. 

Hapatitis  chronica. 

Scrofula  fuppurans. 

Scorbutus  fuppurans. 

Scirrhus  fuppurans. 

Carcinoma. 
1  6.   Arthrocele. 
17.  Arthropuofis  . 
1  8.   Caries  ojfium. 


Ophthalmy,  fuperficial. 
—  -  .  —  lymphatic. 

-  ---  of  horfes. 
Eye-wing. 

Red  eyelids. 

Stye. 

Whitlow. 

Pimpled  face,  hepatic. 

-  -      •     flomatic. 

-  --  hereditary* 
Inflamed  tooth. 


1  1  . 
1  2. 
1  3  . 

14. 
15 


Fiftula  Iacrymalis. 
Fiftula  in  ano. 
Chronical  hepatitis. 
Suppurating  fcrofula. 
Suppurating  fcurvy. 
Suppurating  fcirrhus. 
Cancer. 

Swelling  of  the  joints. 
Suppuration  of  the  joints. 
paries  of  the  bones. 


GENUS  V. 

With  the  Production   of  new  VeJTeh   by  external  Membranes   or 
Glands^  imthout  Fever. 

SPECIES. 

1.  Gonorrhoea  venerea.  Clap. 

2.  Syphilis.  Venereal  difcafe. 

3.  Lepra* 


CLASS  II.  1.6.  OF  SENSATION.  149 

•3.  Lepra.  Leprofy. 

4.  Elephantntfts.  Elephantiafis. 

5.  FrambirftA.  Frambcefia. 

6.  Pfora.  Itch. 

.7.  Pfora  ebriorum.  Itch  of  drunkards. 

8.  Herpes.  Herpes. 

9.  Tsona  ignea.  Shingles. 

10.  Annulus  repens.  Ring. worm. 

11.  Tinea  capitis.  Scald-head. 

1 2.  Crufta  laBea.  JMilk-cruft. 

13.  Tricboma.  Plica  polonica. 

GENUS  VI. 

With  Fever  confequent  to  tie  Production  of  new  Vejfels  or  Fluids* 
SPECIES. 

1.  Febris  fenfiiiva.  Sen fitive  Fever. 

2.  a  pure  claufo.  Fever  from  concealed  matter. 

3.  a  vomica.  ' from  tomica. 

4. ab  empyemate.  from  empyema. 

5.  mefenterica.  — —  mefenteric. 

6.  a  pure  aerato.  from  aerated  matter. 

7.  a  phthifi.  from  confumption. 

8.  fcrofukfa.  fcrofulous. 

9.  ifchiadica.  from  ifchias. 

IQ.  arthropmdica.  from  joint-evil. 

1 1 .  a  pure  contagiofo.  — < —  from  contagious  matter. 

12.  variolofa  fecundaria. fecondary  of  fmall-pox. 

13.  carcinomatofa.  cancerous. 

14.  venerea.  venereal. 

15.  afanie  contagiofa. from  contagious  fanies. 

1 6.  puerpera.  puerperal. 

j  7 .  afphaceh.  from  fphacelus. 

GENUS  VII. 

With  increafed  Afticn  of  the  Organs  cfSenfe. 
SPECIES. 

1 .  Delirium  febrile.  Delirium  of  fevers. 

2.  maniacale. maniacal. 

3.   ebrietatis.  of  drunkennefs 

4.  Somnium.  Dreams. 

5.  Hallufinatio  vifus.  Deception  of  fight. 

^. auditys. of  hearing. 

7.  Rubor  a  calve.  tyluih  from  heat. 

8.   Ruhr 


DISEASES  CLASS  II.  2.  i. 

8.  Rubor  jucunditalis.  Blufh  from  joy. 

9.  Priapifmus  amatorlus.  Amorous  priapifm. 

IQ.  Dtftentio  mamularum.  Detention  of  the  nipples, 

ORDO  II. 

Pecreafed  Sen/at  ion, 

GENUS  I. 

With  dec-reafed  AElion  of  the  general  Syjlern. 
SPECIES. 

1.  StuJtitia  infenfibilis.  Folly  from  infenGbilityv 

2.  Tadium  vita.  Irkfomenefs  of  life. 

3.  Par  efts  fenfitiva.  Senfitive  debility. 

GENUS  II. 

With  decreafed  AElions  of  particular  Organs. 
SPECIES. 

1 .  Anorexia.  Want  of  appetite, 

2.  Adipfm.  Want  of  thirft. 

3.  Impotentia.  Impotence. 

4.  Sleri/itas.  Barrennefs. 

5.  Infenfibilitas  artuum.  Infenfibility  of  the  ^mbs. 

6.  Dyfuria  infenfitivq.  Infenfibility  of  the  bladder^ 

7.  Accumulatio  afoina.  Accumulation  of  feces. 

ORDO  III. 

Retrograde  Senfitive  Motions. 

GENUS  I. 
Of  Excretory  DuEls. 

SPECIES. 
Motus  retrogreffiis.  Retrograde  motion. 

i.  ureterum.  -  —  of  the  ureters. 

2. urethra.  , of  the  urethra. 

3. duclus  coledocL  • —  of  the  bile-du£l. 


CLASS 


CLASS  II.  i.  i.  OF  SENSATION.  151 

CLASS    II. 

DISEASES    OF    SENSATION. 

ORDO  I. 

Inert  afed  Setifatwn. 
GENUS  I. 

With  increafed  Action  of  the  Mufcles. 

THE  actions  belonging  to  this  genus  are  thofe  which  are  im- 
mediately excited  by  the  fenfations  of  pain  or  pleafure,  but 
which  are  neither  followed  by  inflammation  nor  by  convulfion. 
The  former  of  which  belong  to  the  fubfequent  genera  of  this 
order,  and  the  latter  to  the  clafs  of  voluntary  motions. 

The  criterion  between  the  actions,  which  are  the  immediate 
confequence  of  painful  fenfation,  and  convuUive  actions  prop- 
erly fo  called,  confifts  in  the  former  having  a  tendency  to  dif- 
lodge  the  ftimulating  caufe,  which  induces  the  painful  fenfation  ; 
and  the  latter  being  exerted  for  the  purpofe  of  expending  the 
fenforial  power,  and  thus  dulling  or  deftroying  the  general  fen- 
fation of  thefyftem.  See  Clafs  III.  i. 

There  is  a  degree  of  heat  produced  in  the  affected  part  by 
thefe  fenfitive  actions  without  inflammation,  but  in  much  leis 
quantity  than  when  attended  by  inflammation  ;  as  in  the  latter 
there  is  production  of  new  vefTels.  See  Sett.  XXXIII.  2.  3. 

Some  of  the  fpecies  of  this  genus  cannot  properly  be  termed 
difeafes  in  their  natural  ftate,  but  become  fo  by  their  defeat  or 
excefs,  and  are  here  inferted  to  facilitate  the  explanation  of  the 
others. 

SPECIES. 

i.  Degltttiiio.  Swallowing  our  food  is  immediately  caufed 
by  the  pleafurable  fenfation  occafioned  by  its  iiimulus  on  the 
palate  or  fauces,  and  is  acquired  long  before  the  nativity  of  the 
animal.  Afterwards  the  pain  of  hunger  previoufly  produces 
the  various  voluntary  exertions  to  procure  the  proper  material, 
but  the  actions  of  mafiicating  and  of  fwallowing  it  are  effected 
by  the  fenforial  power  of  fenfation  ;  which  appears  by  their  not 
being  always  controlable  by  the  will,  as  when  children  in  vain 
attempt  to  fwallow  naufeous  drugs.  See  Clafs  IV.  i.  3.  i. 

The- 


152  DISEASES  CLASS  n.  i.  2. 

The  mallicated  food  ftimulates  the  palate,  which  is  an  organ  of 
fenfe,  into  fo  much  aftion,  as  to  produce  agreeable  fenfation  ; 
and  the  mufcles  fubfervient  to  deglutition  are  brought  into  ac- 
tion by  the  fenfatioiV  thtfs  produced.  The  pleafurable  fenfa- 
tion is  the  proximate  caufe  ;  the  action  of  the  fibres  of  the  ex- 
tremities of  the  nerves  of  tafte  is  the  remote  caufe  •,  the  fenfo- 
rial  power  of  irritation  exciting  thefe  fibres  of  the  nerves  of  taile 
into  increafed  action  is  the  pre-remote  caufe  ;  the  action  of  the 
mu'fcles  of  deglutition  is  the  proximate  effect  ;  the  pufhing  the 
food  into  the  ftomach  is  the  remote  effe£t ;  and  the  nutrition 
of  the  body  is  thepoft-remoteeffe6t. 

Though  the  mufcles  fubfervient  to  deglutition  have  their  ac- 
tions previouily  afibciated,  fo  as  to  be  excited  into  fynchronous 
tribes  or  fucceifive  trains,  either  by  volition,  as  when  we  fwal- 
low  a  difagreeable  drug  ;  or  by  fenfation,  as  when  we  fwallo\V 
agreeable  food  ;  or  by  irritation,  as  when  we  inattentively  fwal- 
low  our  faliva  ;  yet  do  all  thofe  three  kinds  of  deglutition  belong 
to  the  refpetHve  clafTes  of  volition,  fenfation,  and  irritation; 
becaufe  the  firib  links  of  thefe  tribes  or  trains  of  mufcular  aclion 
are  excited  by  rhofe  fenforial  powers,  and  the  aifociated  links, 
which  accompany  or  fucceed  them,  are  excited  by  the  combined 
powers  either  of  volition,  or  of  fenfation,  or  of  irritation,  along 
with  that  of  affociation. 

2.  Refpiratto.     Refpiration  is  immediately  caufed  by  the  fen- 
forial power  of  fenfation  in  coniequence  of  the  baneful  want  of 
vital  air  ;  and  not  from  the  accumulation  of  blood  in  the  lungs, 
as  that  might  be  carried  on  by  inhaling  azote  alone,  without  the 
oxygenous  part  of  the  atmofphere.     The  action  of  refpiration  is 
thus  fimilar  to  that   offwallowing  our  food  to  appeafe  the  pain 
of  hunger  ;  but  the  lungs  being  furrounded  with  air,  their  prop. 
er  pabulum,  no  interimmediate  voluntary  exertions  are  requir- 
ed, as  in  hunger,  to  obtain  and  prepare  the  wanted  material. 

Refpiration  is  fimilar  to  flow  combuftion  •,  the  oxygenous  part 
of  the  atmofphere  is  received  through  the  moift  membranes, 
which  line  the  air-cells  of  the  lungs,  and  uniting  with  the  in- 
flammable part  of  the  blood  generates  an  acid,  probably  the 
phofphoric  acid  ;  a  portion  of  carbonic  acid  is  likewife  produ- 
ced in  this  procefs ;  as  appears  by  repeatedly  breathing  over 
lime  water,  which  then  becomes  turbid.  See  Botanic  Garden, 
P.I.  Canto  I.  1.  40 1.  note. 

3.  &ttrnutatio.     Sneezing  confifts  of  mufcular  a&ions  produ- 
ced by  the  fenforial  faculty  of  fenfation  ;  and  is  an  effort   to  dif- 
Jodge,  by  means  of  air  forcibly  impelled  through  the  noftrils, 
fome  material ;  which  {limukites  the  membrane,  which  lines 

them, 


CLASS  II.  i.  i.  4-         OF  SENSATION.  153 

them,  into  too  great  action,  and  might  thence  injure  the  fenfe 
of  fmell  which  is  diffufed  on  it. 

In  this  operation  the  too  great  action  of  the  veffds  of  the 
membrane  of  the  noilrils  is  the  remote  caute  ,  the  feniation 
thence  induced  is  the  proximate  caufe  ;  and  the  mufcular  ac- 
tions are  the  proximate  effect. 

This  action  of  freezing  frequently  precedes  common  refpira- 
tion  in  new-born  children,  but  I  believe  not  always  ;  as  like  the 
latter  it  cannot  have  been  previoufly  acquired  in  the  uterus. 

It  is  produced  in  fome  people  by  fudden  light,  as  by  looking 
up  at  the  iky  in  a  morning,  when  they  come  out  of  a  gloomy 
bed-chamber.  It  then  becomes  an  aiTociate  action,  and  beiong-i 
to  Clafs  IV.  i.  2.  2. 

M.  M.  When  it  is-  exerted  to  excefs  it  may  be  cured  by 
fnuffing  ftarch  up  the  noftrils.  See  Clafs  I.  i.  2.  13. 

4.  Anhelltus.  Panting.  The  quick  and  laborious  breathing 
of  running  people,  who  are  not  accuitomed  to  violent  exerciie, 
is  occafioned  by  the  too  great  conflux  of  blood  to  the  lungs.  As 
the  fanguiterous  fyilem,  as  well  as  the  abforbent  fyllem,  is  fur- 
niflicd  in  many  parts  of  its  eourfe  with  valves,  which  in  general 
prevent  the  retrograde  movement  of  their  contained  fluids  ;  and 
as  all  thefe  veffels,  in  fome  part  of  their  courle,  lie  in  contact 
with  the  rnufcles,  which  are  brought  into  action  in  running,  it 
follows  that  the  blood  mult  be  accelerated  by  the  intermitted 
fwelling  of  the  bellies  of  the  mufcles  moving  over  them. 

The  difficulty  of  breathing,  with  which  very  fat  people  are 
immediately  affected  on  exercife,  is  owing  to  the  preffure  of  the 
accumulated  fat  on  the  veins,  arteries,  and  lymphatics  ;  and 
which,  by  diftending  the  {kin,  occafions  it  to  act  as  a  tight  ban- 
dage on  the  whole  furface  of  the  body.  Hence  when  the  muf- 
cles are  excited  into  quicker  action,  the  progrefs  of  the  blood  in 
the  veins,  and  of  the  lymph  and  chyle  in  the  abforbent  fyllem, 
is  urged  on  with  much  greater  force,  as  under  an  artificial  ban- 
dage on  a  limb,  explained  in  Art.  IV.  2.  10.  and  in  Sect. 
XXXIII.  3.  2.-  Hence  the  circulation  is  inftantly  quickened  to 
a  great  degree,  and  the  difficulty  of  breathing  is  the  confequence 
of  a  more  rapid  circulation  through  the  lungs.  The  mere-died 
fecretion  of  the  perfpirable  matter  is  another  confequence  of 
thisrapid  circulation  ;  fat  people, when  at  reft, are  believed  toper- 
fpire  lefs  than  others,  which  may  be  gathered  from  their  generally1 
having  more  liquid  (tools,  more  and  paler  urine;,  and  to  their 
frequently  taking  lefs  food  than  many  thin  people  •,  and  laitly, 
from  the  perfpiration  of  fat  people  being  generally  more  inodo- 
rous than  that  of  lean  ones ;  but  when  corpulent  people  are  put 
in  motion,  the  fweat  (lands  in.  drops  on  theii  Ikins,  and  they 
'  Vot,  II,  W  «Urd 


154  DISEASES  CLASS  II.  i.  t.  $* 

lard  the  ground"  as  they  run.  The  increafe  of  heat  of  corpulent 
people  on  exercife,  is  another  confequence  of  their  more  rapid 
circulation,  and  greater  fecretion.  See  Clafs  I.  2.  3.  17. 

Other  caufes  of  difficult  or  quick  refpiration  will  be  treated 
of  under  Afthma,  Pertuflis,  Peripneumonia,  Tonfillitis. 

5.  Tuffis  ebriorum.     Senfitive  cough  is  an  exertion  of  the 
mufcles  ufed  in  expiration  excited  into  more  violent  action  by 
the  fenforial  power  of  fenfation,  in  confequence   of  fomething 
which  too  powerfully  ftimulates  the  lungs.     As  the  faline  part 
of  the  fecreted  mucus,  when  the  abforptionof  it  is  impeded  ;or 
the  too  great  vifcidity  of  it,  when  the  abforption  is  increafed  ; 
or  the  too  great  quantitiy  of  the  mucus,  when  the  fecretion  is 
increafed  ;  or  the  inflammation  of  the  membranes  of  the  lungs  -y 
it  is  an  effort  to  diflodge  any  of  thefe  extraneous  materials. 

Of  this  kind  is  the  cough  which  attends  free-drinkers  after  a 
debauch  ;  it  confifts  of  many  fhort  efforts  to  cough,  with  a  fre- 
quent expuition  of  half  a  tea-fpoonful  of  frothy  mucus,  and  is 
attended  with  confiderable  thirft.  The  thirft  is  occafioned  by 
the  previous  diflipation  of  the  aqueous  parts  of  the  blood  by  fen- 
fible  or  infenfible  perfpiration  ;  which  was  produced  by  the  in- 
creafed action  of  the  cutaneous  and  pulmonary  capillaries  during 
the  flimulus  of  the  wine.  In  confequence  of  this  an  increafed 
abforption  commences  to  replace  this  moifture,  and  the  (kin  and 
mouth  become  dry,  and  the  pulmonary  mucus  becomes  infpiffa- 
ted  ;  which  ftimulates  the  bronchia,  and  is  raifed  into  froth  by 
the  fucceflive  currents  of  air  in  evacuating  it<  This  production 
of  froth  is  called  by  fome  free-drinkers  "  fpitting  fixpences"  af- 
ter a  debauch.  This  fubfequent  thirft,  dry  mouth,  and  vifcid 
expectoration  in  fome  people  fucceeds  the  flighted  degree  of  in- 
toxication, of  which  it  may  be  efteemed  a  criterion.  See  Clafs 
IV.  2.  i.  8. 

As  coughs  are  not  always  attended  with  pain,  the  mufcular 
actions,  which  produce  them,  are  fometimes  excited  by  the  fen- 
forial faculty  of  irritation,  as  in  Clafs  I.  i.  2.  8.  I.  i.  3.  4. 
I.  i.  4.  3.  I.  2.  3.  4.  Coughs  are  alfo  fometimes  convulfive, 
as  in  Clafs  III.  i.  i.  10.  and  fometimes  fympathetic,  as  in  Clafs 
IV.  2.  i.  7. 

M.  M.  Venefection,  when  the  cough  is  attended  with  in- 
flammation. Mucillages.  Opium.  Torpentia.  Blifter. 

6.  Singultus.     Hiccough  is  an  exertion   of  the  mufcles  ufed 
in  infpiration  excited  into  more    violent  action  by   the  fenforial 
power  of  fenfation,  in  confequence  of  fomething  which  too  pow- 
erfully ftimulates  the  cardia  ventriculi,  or    upper  orifice  of  the 
itomach.     As  when  folid  food  is  too  haitily  taken  without  fuf- 
ficient  dilution.     And  is  an  effort  to  diflodge  that  offeniive  ma- 
terial, 


CLASS  II.  i.  i.  7.        OF  SENSATION.  155 

rial,  and  pufh  it  to  fome  lefs  fenfible  part  of  the  ftomach,  or  in- 
to the  middle  of  the  contained  aliment. 

At  the  end  of  fatal  fevers  it  may  arife  from  the  acrimony  of 
the  undigefted  aliment,  or  from  a  part  of  the  ftomach  being  al- 
ready dead,  and  by  its  weight  or  coldnefs  affe£Hng  the  fiirviving 
part  with  difagreeable  fenfation.  The  pain  about  the  upper 
orifice  of  the  ftomach  is  the  proximate  caufe,  the  too  great  or 
too  little  action  of  the  fibres  of  this  part  of  the  ftomach  is  the  re- 
mote caufe,  the  action  of  the  mufcles  ufed  in  infpiration  is  the 
proximate  effect,  and  the  repercuffion  of  the  offending  material 
is  the  remote  efFecl:. 

Hiccough  is  fometimes  fympathetic,  occafioned  by  the  pain 
of  gravel  in  the  kidney  or  ureter,  as  in  Clafs  IV.  i.  i.  7.  and 
is  fometimes  a  fymptom  of  epilepfy  or  reverie,  as  in  Seel:.  XIX.  2. 

M.  M.  Oil  of  cinnamon  from  one  drop  gradually  increafed 
to  ten,  on  fugar,  or  on  chalk.  Opium,  Blifter.  Emetic. 

7.  Crapula  ventriculi.  Indigeftible  fubftances  in  the  ftomach. 
This  frequently  occurs  in  children,  who  are  reftrained  by  their 
ill-adtive  friends  from  fruit  or  other  fweet  things  ;  and  thus  the 
rational  mind  is  taught  to  fuperintend  the  fatiety  of  the  fenfation 
of  the  fenfe  of  hunger,  or  of  the  pleafure  of  the  palate,  which 
is  contrary  to  nature,  and  a  much  more  erroneons  guide.  Hence 
children  are  liable  to  fwallow  more  plums  and  cherries  than 
their  ftomachs  can  digeft  •,  and  if  thefe  run  haftily  into  ferment- 
ation, much  air,  or  gas,  is  generated  ;  and  produces  an  incon- 
venient diftention  of  the  ftomach,  as  well  as  a  difagreeable  fenfa- 
tion, which  generally  terminates  in  ejecting  the  offending  mat- 
ter by  vomiting. 

In  cows  which  have  eaten  too  much  young  clover,  the  faccha- 
rine  and  mucilaginous  matter,  which  it  contains,  runs  into  fo 
violent  fermentation  as  by  diftention  to  deftroy  the  animal. 
Whence  it  has  been  cuftomary  with  fome  to  perforate  the  fir  It 
ftomach,  and  thus  let  out  the  air.  Dr.  White,  of  Edinburgh, 
afierted,  that  he  witneffed  about  twenty  beafts  in  this  fituation, 
two  were  dead  before  the  medicine  could  be  adminiftered,  but 
to  the  other  eighteen  he  direcled  half  a  pint  of  fpirits,  called  gin 
or  whifky,  mixed  with  as  much  water,  to  be  given ;  and  they 
all  parted  with  much  air  by  eructation,  and  recovered.  An  in- 
genious gentleman  has  lately  put  a  flexible  pipe  down  the  efoph- 
agus  into  the  diftended  ftomach  of  thefe  animals  with  certain 
fuccefs,  as  related  in  fome  late  publication.  A  flexible  tube  for 
this  purpofe  might  be  made  of  wire  wrapped  round  a  flick  about 
half  an  inch  in  diameter,  and  afterwards  covered  with  leather. 

A  boy  about  8  years  old  fwallowed  a  halfpenny,  which  was 
believed  to  pafs  through  him  at  fchool,  fome  weeks  afterwards, 

but 


156  DISEASES  CLASS  II.  i.  i.  S. 

but  he  has  not  recovered  his  health.  I  was  informed,  that  an 
idiot  had  fwallowed  a  half-crown  piece,  and  directed  crude 
quickfilver  to  be  given  him  in  repeated  quantities,  but  never 
heard  the  event  of  the  cafe. 

A  lady  in  my  prefence  was  eating  a  cuftard  out  of  a  tea-cup, 
and  put  3  or  4  pins  into  her  mouth,  which  were  fuppofed  to 
have  been  carelefsly  left  in  the  cup,  and  fwallowed  one  of  them  : 
now,  though  needles  have  found  their  way  out  of  the  body,  and 
other  lharp  indigefdble  materials,  yet  pins  being  terminated 
with  heads  are  faid  often  to  have  occafioned  dangerous  and  pain- 
ful difeafes,  and  fometimes  death.  What  then  Ihould  be  done  ? 
It  occurred  to  me,  that  as  the  head  of  the  pin  would  have  fo 
much  greater  friftion  than  the  point,  that  if  it  was  carried  for- 
wards by  a  dream  of  mucilaginous  fluid,  the  head  muft  go  firft  ; 
and  I  therefore  immediately  directed  an  emetic,  and  the  pin  was 
brought  up  without  any  pain,  or  any  ftains  of  blood  in  the  eject* 
cd  fluid. 

8.  Afihma  humor  ale.  The  humoral  afthma  probably  confifts 
In  a  temporary  anafarca  of  the  lungs,  which  may  be  owing  to  a 
temporary  deleft  of  lymphatic  abforption.  Its  caufe  is  never- 
thelefs  at  prefent  very  obfcure,  fince  a  temporary  deficiency  of 
venous  abforption,  at  the  extremities  of  the  pulmonary  or  bron- 
chial veins,  might  occafion  a  fimilnr  difficulty  of  refpiration.  See 
Abortio,  Clafs  I.  2.  i.  14.  Or  it  might  be  fuppofed,  that  the 
lymph  effufed  into  the  cavity  of  the  cheft  might,  by  fome  addi- 
tional heat  during  fleep,  acquire  an  aerial  form,  arid  thus  com- 
prefsthe  lungs  ;  and  on  this  circumftance  the  relief,  which  thefe 
patients  receive  from  cold  air,  would  be  readily  accounted  for. 

The  paroxyfms  attack  the  patient  in  his  firft  fleep,  when  the 
circulation*  through  the  lungs  in  weak  people  wants  the  afliftance 
of  the  voluntary  power.  Clafs  I.  2,  i.  3.  And  hence  the  ab- 
forbents  of  the  lungs  are  lefs  able  to  fulfil  the  whole  of  their 
duty.  And  part  of  the  thin  mucus,  which  is  fecreted  into  the 
air-cells,  remains  there  unabforbed,  and  occafions  the  difficult 
refpiration,  which  awakes  the  patient.  And  the  violent  exer- 
tions of  the  tnufcles  of  refpiration,  which  fucceed,  are  excited  by 
the  pain  of  fufFocation,  for  the  purpofe  of  pufhing  forwards  the 
blood  through  the  comprefTed  capillaries,  and  to  promote  the  ab- 
forption of  the  efFufed  lymph. 

In  this  the  humoral  differs  from  the  convulfive  aflhma,  treat- 
ed of  in  Clafs  III.  i.  i.  10.  as  in  ihat  there  is  probably  no  ac- 
cumulated fluid  to  be  abforbed  ;  and  the  violent  refpiration  is 
only  an  exertion  for  the  purpofe  of  relieving  pain,  either  in  the 
lungs  or  in  fome  diftant  part,  as  in  other  convulfions,  or  epilep- 
fy  ;  and  in  this  refpecl  the  fits  of  humoral  and  convulfive  afthma 

eflentially 


CLASS  II.  1. 1.  8.         OF  SENSATION.  147 

Mtially  differ  from  each  other,  contrary  to  the  opinion  ex- 
\\  without  fufficient  confideration  in  Seel:.  XVIII.  15. 

The  patients  in  the  paroxyfms  both  of  humoral  and  convullive 
afthma  find  relief  from  cold  air,  as  they  generally  rife  out  of 
bed,  and  open  the  window,  and  put  out  their  heads  ;  for  the 
lungs  are  not  fenfible  to  cold,  and  the  fenfe  of  fuffocation  is  fome- 
\vhat  relieved  by  there  being  more  oxygen  contained  in  a  given 
quantity  of  cold  freih  air,  than  in  the  warm  confined  air  of  a 
ciofe  bed-chamber. 

I  have  feen  humoral  afthma  terminate  in  confirmed  anafarca 
and  deftroy  the  patient,  who  had  been  an  exceflive  drinker  of 
fpirituous  potation.  And  M.  Savage  aliens,  that  this  difeafe 
frequently  terminates  in  diabetes  ;  which  feems  to  (hew,  that  it  is 
a  temporary  dropfy  relieved  by  a  great  flow  of  urine.  Add  to 
this,  that  thefe  paroxyfms  of  the  afthma  are  themfelves  relieved 
by  profufe  fweats  of  the  upper  parts  of  the  body,  as  explained  in 
Clafs  I.  3.  2.  8.  which  would  countenance  the  idea  of  their  be- 
ing occasioned  by  ccngeftions  of  lymph  in  the  lungs. 

The  congeftion  of  lymph  in  the  lungs  from  the  defective  abr 
forption  of  it  is  probably  the  remote  caufe  of  humoral  afthma  ; 
but  the  pain  of  fuffocation  is  the  immediate  caufe  of  the  violent 
exertions  in  the  paroxyfms.  And  whether  this  congeftion  of 
lymph  in  the  air-cells  of  the  lungs  increafes  during  our  ileep,  as. 
above  fuggefted,  or  not ;  the  pain  of  fuffocation  will  be  more 
and  more  diftremng  after  fome  hours  of  fleep,  as  the  fenfibility 
to  internal  ftimuli  increafes  during  that  time,  as  defcribed  in 
Sect.  XVIII.  15.  For  the  fame  reafon  many  epileptic  fits,  and 
paroxyfms  of  the  gout,  occur  during  ileep. 

In  two  gouty  cafes,  complicated  with  jaundice,  and  pain,  and 
ficknefs,  the  patients  had  each  of  them  a  (hivering  fit,  like  the 
commencement  of  an  ague,  to  the  great  alarm  of  their  friends  ; 
both  which  commenced  in  the  night,  I  fuppofe  during  their 
fleep  ;  and  the  confequence  was  a  (reflation  of  the  jaundice,  and 
pain  about  the  ftomach,  and  ficknefs;  and  inftead  of  that  the 
gout  appeared  in  their  extremities.  In  thefe  cafes  I  conjecture, 
that  there  was  a  metaftafis  not  only  of  the  difeafed  action  from 
the  membranes  of  the  liver  to  thofe  of  the  foot ;  but  that  fome 
of  the  new  veflels,  or  new  fluids,  which  were  previoufly  produ- 
ced in  the  inflamed  liver,  were  tranil.ited  to  the  feet  during  the 
cold  fit,  by  the  increafed  abforption  of  the  hepatic  lymphatics, 
and  by  the  retrograde  motions  of  thofe  of  the  affected  limbs. 

This  I  think  refembles  in  fome  refpecls  a  fit  of  humoral  afth- 
ma, where  ftronger  motions  of  the  ablbrbent  veflels  of  the  lungs 
are  excited,  and  retrograde  ones  of  the  correfpondent  cutaneous 
lymphatics  ;  whence  the  violent  fweats  of  the  upper  parts  of  the 

body 


158  DISEASES  CLASS  II.  i.  i.  9. 

body  only  are  produced  ;  and  for  a  time  the  patient  becomes  re- 
lieved by  the  metaftafis  and  elimination  of  the  offending  material 
by  fenfitive  exertion.  For  a  further  account  of  this  intricate 
fubjea  feeClafsIII.  i.  i.  10. 

M.  M.  To  relieve  the  paroxyfm  a  tea-fpoonful  of  ether  may 
be  given  mixed  with  water,  with  10  drops  of  laudanum,  to  be 
repeated  three  or  four  times.  Venefedion.  An  emetic.  A 
bliiler.  Afterwards  the  Peruvian  bark,  with  a  grain  of  opium 
at  night,  and  two  or  three  of  aloes.  A  flannel  fhirt  in  winter 
but  not  in  fummer.  IlTues.  Digitalis  ? 

In  this  fpecies  of  afthma,  there  is  great  reafon  to  believe,  that 
the  refpiration  of  an  atmofphere,  with  an  increafed  proportion  of 
oxygen,  will  prove  of  great  advantage  ;  fome  well  obferved  and 
well  attefted  cafes  of  which  are  publimed  by  Dr.  Beddoes  ;  as 
this  purer  air  invigorates  the  circulation,  and  the  whole  fyftem 
in  confequence,  perhaps  not  only  by  its  ftimulus,  but  by  its  fup- 
plying  the  material  from  which  the  fenforial  power  is  extracted 
or  fabricated.  In  fpafmodic  afthma,  on  the  contrary,  Dr.  Fer- 
riar  has  found  undoubted  benefit  from  an  atmofphere  mixed  with 
hydrogen.  See  Sed.  XVIII.  15.  and  Clafs  III.  i.  i.  10. 

9.  NiHitatiofenfitiva.  Winking  of  the  eyes  is  performed  eve- 
ry minute,  without  our  attention,  for  the  purpofe  of  difFufing 
the  tears  OVCIF  them,  which  are  poured  into  the  eye  a  little  above 
the  external  corner  of  it,  and  which  are  afterwards  abforbed  by 
the  lachrymal  points  above  and  below  the  internal  corner  of  it. 
"When  this  operation  is  performed  without  our  attention,  it  is 
caufed  by  the  faculty  of  irritation,  and  belongs  to  Clafs  I.  1.4. 
i.  but  when  it  is  produced  by  a  ftronger  ftimulus  of  any  extra- 
neous material  in  the  eye,  fo  as  to  caufe  pain,  the  violent  and  fre- 
quent nictitation  is  caufed  by  the  faculty  of  fenfation. 

This  difeafe  is  fometimes  produced  by  the  introverfiori  of  the 
edge  of  the  lower  eyelid,  which  bends  the  points  of  the  hairs  of 
the  eyeladi  upon  the  ball  of  the  eye,  which  perpetually  (limulate 
it  into  painful  fenfation.  This  introverfion  of  the  eyelid  is  gen- 
erally owing  to  a  tumour  of  the  cellular  membrane  below  the 
edge  of  the  eyelid,  and  though  a  very  troublefome  complaint  may 
often  be  cured  by  the  following  fimple  means.  A  little  common 
plafter  fpread  on  thin  linen,  about  a  quarter  of  an  inch  long, 
rnuft  be  rolled  up  fo  as  to  be  about  the  fize  of  a  crow-quill ; 
this  mull  be  applied  immediately  below  the  eyelafh  on  the  out- 
fide  of  the  eye,  and  muft  be  kept  on  by  another  plafter  over  it. 
This  will  then  aft  as  a  flight  compreilion  on  the  tumor  under 
the  eyelafh,  and  will  prevent  the  hairs  from  touching  the  eye- 
ball. In  a  week  or  two  the  comprcffion  will  diminiih  the  tu- 
mor it  lies  over,  and  cure  this  painful  deformity. 

I  o.    Of  at  at  id 


CLASS  II.  i.  1. 10.       OF  SENSATION. 

10  Qfcitntio  et  patidiculatio.  Yawning  and  ftretching  of  the 
limbs  is  produced  either  by  a  long  inactivity  of  the  mufcles  now 
brought  into  action,  as  fometimes  happens  after  deep,  or  after 
liftening  a  long  time  to  a  dull  narrative  ;  or  it  is  produced  by  a 
too  long  continued  action  of  the  antagonift  muicles.  In  the 
former  cafe  there  is  an  accumulation  of  fenforial  power  during 
the  quiefcence  of  the  mufcles  now  brought  into  action  ;  which 
probably  conftitutes  the  pain  or  wearifomenefs  of  a  continued 
attitude.  In  the  latter  cafe  there  is  an  exhauftion  of  fenforial 
power  in  the  mufcles,  which  have  lately  been  acting  violently, 
and  a  confequent  accumulation  in  the  mufcles,  which  are  antag- 
onifts  to  them,  and  which  were  at  reft. 

Thefe  involuntary  motions  are  often  feen  in  paralytic 
limbs,  which  are  at  the  fame  time  completely  difobedient  to  the 
will ;  and  are  frequently  obfervable  in  very  young  children  ;  and 
from  thence  we  may  conclude,  that  thefe  motions  are  learnt  be- 
fore nativity  ;  as  puppies  are  feen  to  open  their  mouths  before 
the  membranes  are  broken.  See  Seel.  XVI.  2. 

Where  thefe  motions  are  obferved  in  limbs  otherwife  paralyt- 
ic, it  is  an  indication  that  electric  fhocks  may  be  employed  with 
advantage,  as  the  excitability  of  the  limb  by  irritation  is  not  ex- 
tinct, though  it  be  difobedient  both  to  volition  and  fenfation. 

n.  Temfmus  confifts  in  violent  and  frequent  ineffectual  ef- 
forts to  difcharge  the  contents  of  the  rectum,  owing  to  pain  of 
the  fphincter.  The  pain  is  produced  by  indurated  feces,  or  by 
fome  acrid  material,  as  the  acidity  of  indigefted  aliment ;  and 
the  efforts  are  attended  with  mucus  from  the  pained  membrane. 
The  feces  muft  fometimes  be  taken  away  by  the  end  of  a  mar- 
row-fpoon,  as  cathartics  and  even  clyfters  will  pafs  without  re- 
moving them.  It  is  fometimes  caufed  by  fympathy  with  the 
urethra, -when  there  is  a  ftone  at  the  neck  of  the  bladder.  See 
ClafsII.  2.  2.  7.  and  IV.  i.  2.  8. 

M.  M.  Fomentation,  an  enema  with  mucilage  and  laudanum. 

The  common  exclufion  of  the  feces  from  the  rectum  is  a  pro- 
cefs  fimilar  to  this,  except  that  the  mufcles  of  the  fphincter  ani, 
and  thofe  of  the  abdomen,  which  act  along  with  them  by  the 
combined  powers  of  fenfation  and  affociation,  are  in  tenefmus 
excited  by  painful  fenfation,  and  in  the  latter  by  a  fenfation, 
which  may  in  fome  inftances  be  almoft  called  pleafurable,  as  re- 
lieving us  from  a  painful  one  in  the  exclufion  of  the  feces. 

1 2.  StraagurJa.  Strangury  confifts  in  painful  efforts  to  dif- 
charge the  contents  of  the  urinary  bladder.  It  is  generally  ow- 
ing to  a  ftone  in  the  fphincter  of  the  bladder  ;  or  to  the  inflam- 
mation of  the  neck  of  it  occafioned  by  cantharides.  It  is  fome- 
times caufed  by  fympathy  with  the  piles  ;  and  then  is  liable  in 

women 


!6o  DISEASES  CLASS  II.  i.  i.  13. 

women  to  occafion  convulfions,  from  the  violence  of  the  pain 
without  inflammation.     See  Clafs  IV.  2.  2.  2.  and  3. 

M.  M.  Fomentation  clyfter  with  oil  and  laudanum,  pivfh  the 
flone  back  with  a  bougie  ;  if  from  cantharides,  give  hall'  a  pint 
of  warm  water  every  ten  minutes.  Mucilage  of  gum  arabic  and 
tragacanth. 

The  natural  evacuation  of  the  urine  is  a  procefs  fimilar  to  this, 
except  that  the  mufcular  fibres  of  the  bladder,  and  the  mufcles 
of  the  abdomen,  which  act  in  concert  with  them  by  the  combi- 
ned powers  of  fenfation  and  of  aUbciation,  are,  in  the  former 
cafe  of  ftrangury,  excited  into  action  by  painful  fenfation  j  and 
in  the  latter  by  a  fenfation,  which  may  almoft  be  termed  pleafur- 
able,  as  it  relieves  us  from  a  previous  uneafy  one. 

The  ejectio  feminis  is  another  procefs  in  fome  refpects  fimilar 
to  ftrangury,  as  belonging  to  the  fame  fenfible  canal  of  the  ure- 
thra, and  by  exciting  into  action  the  acceleratory  mufcles ;  but 
in  the  ftrangury  tliefe  mufcles  are  excited  into  action  by  painful 
fenfation,  and  in  the  ejection  of  the  femen  by  pleafurable  fenfa- 
tion. 

13.  Parturitto.  Parturition  is  not  a  difeafe,  it  is  a  natural  pro- 
cefs, but  is  more  frequently  unfortunate  in  high  life  than  amongft 
the  middle  clafs  of  females  ;  which  may  be  owing  partly  to 
fear,  with  which  the  priefts  of  LUCINA  are  liable  to  infpire  the 
ladies  of  faftiion  to  induce  them  to  lie-in  in  town  j  and  partly 
to  the  bad  air  of  London,  to  which  they  purpofely  refort. 

There  are  however  other  caufes,  which  render  parturition 
more  dangerous  to  the  ladies  of  high  life  j  fuch  as  their  greater 
general  debility  from  neglect  of  energetic  exercife,  their  inexpe- 
rience of  the  variations  of  cold  and  heat,  and  their  feclulion 
from  frem  air.  To  which  mult  be  added,  that  great  fource  of 
the  destruction  of  female  grace  and  beauty,  as  well  as  of  female 
health,  the  tight  ftays  and  other  bandages,  with  which  they  are 
generally  tortured  in  their  early  years  by  the  active  folly  of  their 
friends,  which  by  difplacing  many  of  the  vifcera  impedes  their 
actions,  and  by  compremng  them  together  produces  adhefions  of 
one  part  to  another,  and  affects  even  the  form  and  aperture  of 
the  bones  of  the  pelvis,  through  which  the  nafcent  child  mud 
be  protruded. 

As  parturition  is  a  natural,  not  a  morbid  procefs,  no  medicine 
fhould  be  given,  where  there  is  no  appearance  of  difeafe.  The 
abfurb  cuftom  of  giving  a  powerful  opiate  without  indication  to 
all  women,  as  foon  as  they  are  delivered,  is,  I  make  no  doubt, 
frequently  attended  with  injurious,  and  fometimes  with  fatal 
eonfequences.  See  Clafs  II.  i.  2.  16. 

Another  thing  very  injurious  to  the  child,  is  the  tying  and 

cutting 


CLASS  II.  i.  1. 13.        OF  SENSATION.  i£i 

cutting  the  navel-firing  too  foon  ;  which  fhould  always  be  left 
till  the  child  has  not  only  repeatedly  breathed,  but  till  all  pulfa- 
tion  in  the  corci  ceafes.  As  otherwrfe  the  child  is  much  weaker 
than  it  ought  to  be  -,  a  part  of  the  blood  being  left  in  the  pla- 
centa, which  ought  to  have  been  in  the  child  5  and  at  the  fame 
time  the  placenta  does  not  fo  naturally  collapfe,  and  withdraw  it- 
felf  from  the  fides  of  the  uterus,  and  is  not  therefore  removed  with 
fo  much  fafety  and  certainty.  The  folly  of  giving  rue  or  rhu- 
barb to  new-born  children,  and  the  danger  of  feeding  them  with 
gruel  inflead  of  milk,  is  fpoken  of  in  Clafs  I.  i.  2.  5.  and  II.  i. 
2,  16.  4 

Many  ladies  become  difeafed  by  an  unnatural  refufal  of  giving 
fuck  to  their  child,  which  ought  to  relieve  their  breads  of  the 
load  of  milk,  arid  give  confolation  to  their  minds  by  the  floras 
or  love  to  their  infant.  Many  ladies  indeed  experience  a  diiR- 
culty  in  nurfing  their  children  from  their  not  having  nipples  to 
their  breafls  -,  which  have  been  often  inflamed  and  deftroyed  iu 
their  early  years,  even  in  their  infancy,  as  I  have  fecn,  by  the 
hard  edge  of  (tiff  flays  rubbing  againfl  them,  and  fomedtnes,  I 
believe,  by  the  fmall-pox. 

M.Herholdt,  of  Copenhagen, has  announced  a  difcovery  which 
he  thinks  highly  interefling  to  humanity  ;  which  is,  that  the 
apparent  death  of  new-born  infants  arifes  from  the  trachea,  or 
wind-pipe,  being  filled  with  water  ;  and  that  they  may  be  gen- 
erally faved  by  giving  them  fuch  an  inclined  poOtion,  that  the 
water  may  run  out.  Of  thirteen  children,  which  were  fuppofed 
to  be  dead  or  flill-born,  he  fays,  that  twelve  recovered  by  thefe 
fimple  means.  As  the  trachea  may  not  have  acquired  due  fen- 
fibility  before  delivery,  in  fome  feeble  or  premature  births,  this 
circumflance  may  poflibly  arife,  though  it  feldom  occurs  even  in 
drowned  people.  Medical  Review,  July,  1799. 


VOL.  11  X  OR5DO 


i6a-  DISEASES  CLASS  II.  1.2. 

ORDO  I. 

Increafed  Senfattati. 
GENUS  II. 

With  the  Production  of  new  VeJJels   by  internal  Membranes  or 
Glands,  with  Fever. 

IN  the  firft  clafs  of  difeafes  two  kinds  offerers  were  defcri- 
bed,  one  from  excefs,  and  the  other  from  defect  of  irritation  ; 
and  were  in  confequence  termed  irritative,  and  inirritative  fevers. 
In  this  fecond  clafs  of  difeafes  another  kind  of  fever  occurs, 
which  is  caufed  by  excefs  of  fenfation,  and  termed  in  confe- 
quence Senfitive  Fever.  But  there  is  no  fever  from  defect  of 
fenfation,  becaufe  the  circulation  is  carried  on  in  health  without 
our  confcioufnefs,  that  is,  without  any  fenfation  attending  it. 

But  as  excefs  of  fenfation  may  exift  with  excefs  or  defect  of 
irritation,  two  other  kinds  of  fever  arife  from  a  combination  of 
fenfitive  fever  with  the  irritative,  and  inirritative  ones.  Making 
five  kinds  in  all. 

1.  Irritative  fever,  defcribed  in  Clafs  I.  I.  I.  i. 

2.  Inirritative  fever.     Clafs  I.  2«  i.  I. 

3.  Senfitive  fever.     Clafs  II.  1.6.  i. 

4.  Senfitive  irritated  fever.     Clafs  II.  1.2.  I. 

5.  Senfitive  inirritated  fever.     Clafs  II.  i.  3.  i. 

As  the  fenfitive  irritated  fever  attends  all  the  difeafes  enumer- 
ated under  the  genus  about  to  be  defcribed,  it  is  placed  at  the 
head  of  it.  And  as  the  fenfitive  inirritated  fever  accompanies 
the  greateft  number  of  the  fpecies  enumerated  under  the  third 
genus  of  this  order,  it  is  placed  at  the  head  of  them.  And  as 
the  fenfitive  fever  attends  the  difeafes  of  the  fixth  genus,  it  is 
placed  at  the  head  of  them.  But  as  every  febrile  paroxyfm  con- 
fids  of  difordered  tribes  or  trains  of  aflbciated  motions,  it  may  be 
doubted,  whether  they  ought  not  all  to  have  been  placed  in  the 
fourth  clafs,  amongft  the  difeafes  of  afTociation.  See  Clafs  IV. 
2.4.  n. 

All  the  fubfcquent  fpecies  of  this  genus  are  attended  with  fen- 
fitive irritated  fever  ;  there  are  neverthelefs  fome  fuperficiai  in- 
flammations, which  affect  the  fame  fituations  without  much  fever, 
as  the  fcrofulous  ophthalmy  and  fpurious  peripneumony, 
which  belong  to  other  genera. 

Inflammation  is  uniformly  attended  with  the  production  or 
fecretion  of  new  fibres  conftituting  new  vefiels  5  this  theieibre 

may 


CLASS  II.  i.  2.  i.        OF  SENSATION.  163 

fli-y  be  eilecmed  its  eflential  character,  or  the  criterion  of  its 
exiftence.  The  extenfion  of  the  old  veflels  feems  rather  3  con- 
fequence  than  a  caufe  of  the  germination,  or  puli'ulation,  of  thefe 
ncu  ones;  for  the  old  veflels  may  be  enlarged,  and  excited  with 
ial  energy,  without  any  production  of  new  ones,  as  in  the 
bluih  of  (hame  or  of  anger. 

When  thefe  new  veiiels  are  formed,  if  they  are  not  reabforbed 
into  the  circulation,  they  fecrete  a  new  fluid  called  purulent 
matter  ;  which  generally  opens  itfeif  a  paflage  on  the  external 
(kin,  and  produces  an  ulcer,  which  cither  gradually  h?ab,  or 
fpreads,  and  is  the  caufe  of  hectic  fever  ;  or  they  fecrete  conta«- 
gious  matter,  which  has  the  property  of  exciting  the  fame  kind 
of  inflammation,  and -of  producing  the  fame  kind  of  contagious 
matter,  when  inferted  by  inoculation  into  the  fkin  of  other  per- 
fons.  Thefe  contagious  matters  form  ulcers,  which  either  heal 
fpontaneoufly,  or  by  art ;  or  continue  to  fpread,  and  dcftroy  the 
patient,  by  other  kinds  of  hectic  lever. 

In  this  genus  there  is  an  increafe  of  the  fenforial  power  of  ir- 
ritation as  well  as  of  fenfation  ;  whence  great  arterial  energy  is 
produced, and  the  pulfe  becomes  ftrong  and  full, as  well  as  quick; 
and  the  coats  of  the  arteries  feel  hard  under  the  finger,  being 
themfelves  thickened  and  diftended  by  inflammation.  The 
blood  drawn,  efpecially  at  the  fecond  bleeding,  is  covered  with 
a  tough  fize  ;  which  is  probably  the  mucus  from  the  inflamed 
internal  furface  of  the  arteries,  increafed  in  quantity,  and  more 
coagulable  than  in  its  natural  (late ;  the  thinner  part  being  more 
perfectly  abforbed  by  the  increafed  action  of  the  inflamed  abforb- 
ents.  See  Seel.  XXXIII.  2.  2.  This  is  rendered  more  prob- 
able, becaufe  the  hard  feel  of  the  pulfe,  and  the  abundance  of 
coagulable  lymph  commence,  exift,  and  ceafe  together. 

Great  heat  is  produced  from  the  new  chemical  combinations 
arifing  in  the  fecretion  of  new  fibres,  and  great  pain  from  the 
diftention  of  old  ones,  or  from  their  increafed  adlion.  The  in- 
creafed quantity  of  fenfation  from  a  topical  inflammation  or 
phlegmon  is  the  immediate  caufe  of  the  febris  fenfitiva  irritata, 
or  inflammatory  fever  ;  as  when  it  arifes  from  the  pain  of  pleu- 
rify,  or  paronychia ;  but  generally  an  irritative  fever  precedes 
this  topical  inflammation,  which  occurs  during  the  hot  fit  of  it ; 
and  then  the  irritative  fever  is  changed  into  a  fenfitive  irritated 
fever,  by  the  additional  caufe  of  the  fenforia-1  power  of  fenfation 
befides  that  of  irritation. 

SPECIES. 

I.  Febns fenfitiva  irritata.      Senfitive  irritated  fever,  or  in- 

flammatorr 


i<54  DISEASES  CLASS  II.  i.  2.1, 

flammatory  fever.  Phlegmafia.  A  flrong  full  pulfe,  with  in- 
flammation of  the  coats  of  the  arteries,  conftitutes  this  difeafe. 
Jt  originates  from  fome  topical  inflammation,  whieh,  if  the  fever 
is  not  fubdued,  terminates  in  fuppuration  ;  and  differs  from  ir- 
ritative fever  in  refpeft  to  the  painful  fenfation  which  accompa- 
nies it.  For  as  pleafurable  fenfation  i*  the  caufe  of  the  growth 
of  the  new  veflels,  and  diftention  of  the  old  ones,  in  the  natural 
enlargement  of  the  body  during  our  infancy  ;  fo  a  painful  fenfa- 
tion is  the  caufe  of  the  unnatural  production  of  new  veffels,  and 
enlargement  of  old  ones  in  inflammatory  difeafes. 

When  matter  is  thus  formed  in  any  internal  vifcus,  or  in 
the  cellular  membrane,  as  in  the  lungs  or  liver;  fo  long  as  this 
abfcefs  remains  without  admiffion  of  air,  this  inflammatory  fever 
is  Jiable  to  continue,  recieving  only  temporary  relief  by  bleeding 
or  emetics,  or  cathartics  •,  till  the  patient,  after  a  month,  or  two, 
or  three,  expires.  But,  if  air  be  admitted  to  thefe  internal  ab- 
fcefles,  this  kind  of  fever  is  changed  into  a  heftic  fever  in  a  fin- 
gle  day.  It  alfo  fometimes  happens,  that  when  the  abfcefs  re- 
mains unopened  to  the  air,  if  the  matter  has  become  putrid,  hec- 
tic fever  iupervenes,  with  colliquative  fweats,  or  diarrhoea ;  the 
matter  in  both  cafes  is  fometimes  abforbed,  and  the  fides  of  the 
abfcefs  grow  together  again  without  an  external  aperture.  See 
ClafsII.  1.4.  i.  and  2.  Another  termination  of  inflammation 
is  in  gangrene,  but  this  belongs  to  the  inflammation  of  the  ex- 
ternal ikin  *,  as  the  production  of  purulent  matter  belongs  to  in- 
flammation of  the  internal  or  mucous  membranes.  Thus  when 
the  external  fkin  is  the  feat  of  inflammation,  as  in  erythema,  or 
eryfipelas,  and  produces  fenfitive  irritated  fever,  no  collection  of 
purulent  matter  can  be  formed  ;  but  a  material  oozes  out,  and 
lies  upon  the  furface,  like  that  in  the  confluent  fmall-pox,  and 
the  cuticle  at  length  peels  off,  or  gangrene  fupervenes.  It  mutt 
be  noted,  thnt  thefe  kinds  of  inflammation  can  exitl  together  ; 
and  fome  parts  of  the  cellular  membrane  may  fuppurate  at  the 
fame  time  that  the  external  Ikin  is  affected  with  erythema,  or 
eryfipehs. 

M.  M.  Venefeclion.  Cathartics.  Diluents.  Cool  air. 
Torpentia.  Cold  bath  ?  See  Sett.  XII.  6. 

The  increafed  arterial  a6Hon  in  this  fenfitive  irritated  fever  is 
not  fimply  owing  to  the  increafed  irritability  of  the  arterial  fyf- 
fem,  or  to  the  ftimuius  of  the  diftention  of  the  veiTels,  but  aifo 
to  the  increafed  acrimony  or  pungency  of  the  blood  ;  which 
has  now  fo  far  changed  its  nature  as  to  become  more  fluid, 
rnore  denfe,  and  to  be  loaded  with  coagulable  lymph.  Hence 
it  becomes  neceffary  not  only  to  leflen  the  quantity  of  blood 
by  venefetlion  and  by  cathartics,  but  alfo  to  dilute  its  acrimo- 
ny* 


CLASS  II.  i.2.  2.       OF  SENSATION.  165 

rv,  or  pungency,  by  the  introduction  of  aqueous  and  mucilagin- 

:!uids,  iuch  as  barley   water,   cream    and   water,   fugar  and 

water,  weak  broths  ;  to  which  may  be  added  fo  much  of  fome 

vegetable  eflential  oil,  as  may  render  them  grateful  to  the  (tom- 

and  thus  promote  their  abforption  ;  as    by  infufing  parfley 

;ilery  and   turnips  in  the  broth  ;  or  by  balm,  mint,  or  fage 

teas. 

The  following  fpecies  of  this  genus  only  diftinguifli  the  fitua- 
tion  of  the  part  previoufly  inflamed,  and  which  is  the  remote 
caufe  of  the  fenutive  irritated,  or  inflammatory  fever,  which  at- 
tends it. 

2.  Ophthalmia  interna.  Inflammation  of  the  eye  is  attended 
with  the  production  of  new  veflels,  which  fpread  over  the  tunica 
adjunctiva,  and  over  the  cornea  ;  thefe  new  veffels  are  eafily 
feen,as  they  lie  on  a  white  ground,  an.d  give  ocular  demonftra- 
tion  of  their  production  in  inflammation.  When  this  inflamma- 
tion of  the  cornea  fuppurates,  it  is  liable  to  leave  little  ulcers, 
which  may  be  feen  beneath  the  furface  in  the  form  of  little  ex- 
cavations ;  and  as  thefe  heal,  they  are  liable  to  be  covered  with 
an  opaque  fear.  This  fear,  in  fome  months  or  years,  is  liable  to 
wear  away,  and  become  tranfparent,  without  the  afliilance  of 
any  polifhing  powder,  as  of  very  finely  levigated  glafs,  as  fome 
have  recommended.  But  when  the  cornea  is  affected  through 
all  its  thkknefs,  the  return  of  its  tranfparency  becomes  hopelefs. 
See  Clafs  I.  i.  3.  14. 

la  violent  degrees  of  ophthalmy  the  internal  parts,  as  the  reti- 
na, optic  artery,  iris,  ciliary  procefs,  become  inflamed,  as  well 
as  the  external  ones  ;  hence  the  leaft  light  admitted  to  the  eye 
occafions  intolerable  pain.  This  curious  circumftance  cannot 
be  owing  to  the  action  of  light  on  the  inflamed  veflels  of  the 
cornea  ;  it  therefore  mews,  that  the  extremity  of  the  optic  nerve 
or  retina  is  alfo  rendered  more  exquifitely  fenfible  to  light,  by 
partaking  of  the  inflammation  ;  arid  I  have  been  told,  that  red 
colours  are  in  thefe  cafes  fometimes  painfully  perceived  even 
in  perfedt  darknefs.  This  (hews  that  the  retina  is  excited  into 
motion  by  the  ftimulus  of  light ;  and  that,  when  it  is  inflamed, 
thefe  motions  give  great  pain,  like  thofe  of  other  inflamed  parts, 
3S  the  mufcles,  or  membranes.  And  fecondly,  that  the  ideas 
of  colours  confiil  in  the  motions  of  the  retina  ;  which  ideas 
occafion  pain,  when  the  extremity  of  the  moving  nerve  is  in- 
flamed. 

M.  M.  Venefe&ion.  Cathartics.  Diluents.  Torpenfia. 
Frequently  moiften  the  eye  with  cold  water  by  means  of  a  rag. 
Cool  airy  room.  Darknefs.  When  the  inflammation  begins  to 
4ecline,  white  vitriol  gr.  vi.  in  an  ounce  of  water  is  more  effica- 
cious 


DISEASES  CLASS  II.  i.  2. 


c:o»: ,?  to  moiften  the  eye  than  folutions  of  lead.  Tincture  of 
plum  diluted.  Extracb  of  belladonna.  New  veffels  from  the 
inflamed  tunica  adnata  frequently  fpread  like  a  fly's  wing  upon 
the  tranfparent  cornea,  which  is  then  called  Pterigium.  To 
ftop  the  growth  of  this,  the  principal  veflels  ffoould  be  cut  through 
with  a  lancet.  When  the  inflammation  begins  to  decline,  after 
tiue  evacuation  any  ftimulating  material  put  into  the  eye  increaf- 
es  !•  i,  which  foon  removes  the  new  red  veflels  £ 

en  rife  to  a  hundred  famous  eye-waters,  and  eye- 
do  tiers;  it 'thefe  ftimulating  materials  are  ufed  too  foon,  the 
inflammation  is  increafed  by  them.  See  Seel:.  XXXII.  2.  icr 
Ciafs  I.  2,  2.  13. 

There  is  another  ophthalmia,  which  attends  weak  children, 
avid  is  generally  efteemed  a  fymptom  of  fcrofula,  as  defcribed 
-inClafstl.  i.  5.  3.  and  another,  which  is  of  venereal  origin, 
mentioned  in  Clafs  II.  i.  5.  2.  both  which  may  be  termed 
ophthalmia  fuperficialis. 

3.  Pbrenitis.  Inflammation  of  the  brain  is  attended  with  in- 
tolerance of  light  and  found  j  which  (hews,  that  the  extremities 
of  the  nerves  of  thofe  fenfes  are  at  the  fame  time  inflamed  ;  it  is 
alib  attended  with  great  pain  of  the  head,  with  watchfulnefs,  and 
furious  delirium.  The  violent  efforts,  thefe  patients  are  fatd 
fometimes  to  exert,  are  owing  to  the  increafed  fecretion  of  fenfo- 
power  in  the  brain;  as  all  other  inflamed  glands  have  a 
greater  circulation  of  blood  parting  through  them,  and  a  greater 
iecretion  in  confequence  of  their  peculiar  fluids,  as  in  the  hepa- 
titis much  more  bile  is  generated. 

M.  M.  Veneft-clion.  Cathartics.  Torpentia.  Foment  the 
head  with  cold  water  for  hours  together.  Or  with  warm  water. 
Cool  airy  room.  Afterwards  cupping  on  the  occiput.  Leeches 
to  the  temples.  When  the  patient  is  weakened  a  blifter  on  the 
head,  and  after  further  exhauftion  five  or  fix  drops  of  tincture 
of  opium. 

4.  Peripneumonia.  Inflammation  of  the  lungs.  The  pulfe  is 
not  always  hard,  fometimes  foft ;  which  is  probably  owing  to  a 
degree  of  ficknefs  or  inaction  of  the  ftomach  j  with  dull  pain  of 
the  cheft  ;  refpiration  conftantly  difficult,  fometimes  with  erecl: 
pouure-,  the  face  bloated  and  purplifh;  cough  generally  with 
moiit  expectoration,  often  ftained  with  blood. 

When  the  difficulty  of  refpiration  is  very  great,  the  patient  is 
not  able  to  cough ;  in  this  fituation,  after  copious  bleeding,  the 
cough  is  liable  to  return,  and  is  fo  far  a  favourable  fymptom,  as  it 
ihews  fome  abatement  of  the  inflammation. 

A  peripneumony  frequently  occurs  in  the  chin-cough* 
and  deftroys  the  patient,  except  immediate  recourfe  be  had  to 

the- 


CLASS  II.  i.  ft.  4.         OF  SENSATION. 

the  lancet,  or  to  four  or  five  leeches  ;   when   blood  cannot  be 
otherwife  taken. 

The  peripneumony  is  very  fatal  to  young  children,  efpec! 
as  I  believe  it  is  frequently  miftaken  for  a  fpaimodic  afthma,  or 
for  the  croup,  or  cynanche  trachea  1  is  oi  Cullen.     Both  w. 
-however,  when  they  occur,    require  immediate    venelection  by 
*he  lancet  or  by  leeches,  as  well  as  the   peripneumony  j  as  i 
tioned  below. 

Inflammation  of  the  lungs  is  alfo  liable  to  occur  in  the  meafles, 
•and  in  the  hooping-cough,  and  inuft  be  attacked  by  venefeclion 
at  any  time  of  the  difeafe ;  otherwife  either  a  preient  death,  or 
an  incurable  confumption,  is  the  confequence. 

The  peripneumony  is  frequently  combined  with  inflammation 
of  the  pleura,  and  fometimes  with  that  of  the  diaphragm  j  cither 
of  thefe  may  generally  be  diftinguifhed,  not  only  by  the"  pain 
which  attends  inflammation  of  thefe  membranes,  but  by  infpect- 
ing  the  naked  cheft,  and  obferving  whether  the  patient  breathes 
more  by  elevating  the  ribs,  or  by  deprefling  the  diaphragm. 

A  crifis  happens  in  children  about  the  fixth  day  with  much 
pale  urine,  which  mud  be  waited  for  after  evacuations  have  been 
ufed,  as  far  as  can  be  done  with  fafety  ;  in  this  fituation  the 
warm  bath  twice  a  day,  and  fmall  blifters  repeatedly  in  fuccef- 
fion,  are  of  peculiar  fervice. 

After  the  termination  of  peripneumony  a  collection  of  coag- 
ulable  lymph  is  frequently  left  in  the  cavity  of  the  cheft  unabforb- 
€d-,  or  a  common  anafarca  of  the  lungs  occurs  from  the  prefent 
inaction  of  the  abforbent  veiTels,  which  had  previoufly  been  ex- 
cited too  violently.  This  difficulty  of  breathing  is  cured  or  re- 
lieved by  the  exhibition  of  digitalis.  See  Art.  IV.  2.  7. 

M.  M.  The  lancet  is  the  anchor  of  hope  in  this  difeafs ; 
which  inuft  be  repeated  four  or  five  times,  or  as  often  as  the  fe- 
ver and  difficulty  of  breathing  increafe,  which  is  generally  in 
the  evening ;  antimonials,  diluents,  repeated  fmall  blifters  about 
the  cheft,  mucilage,  pediluvium,  warm  bath.  Is  a  decoction 
of  feneca-root  of  ufe  ?  Do  not  neutral  fahs  increafe  the  tenden- 
cy to  cough  by  their  ftimulus,  as  they  increafe  the  heat  of  urine 
in  gonorrhoea  ?  Children  in  every  kind  of  difficult  breathing, 
from  whatever  caufe,  fhould  be  kept  as  upright  in  bed  as  may- 
be, and  continually  watched  ;  fmce,  if  they  ilip  down,  they  are 
liable  to  be  immediately  fufFocated  :  to  prevent  which  a  pillow 
fhould  be  put  beneath  the  undermoft  (beet  half  way  down  in  the 
bed,  fo  as  to  receive  the  pofteriors  of  the  child,  and  thus  coun- 
teract its  (lid ing  down  lower  ;  or  drawer:*  on  the  thighs  might 
be  occafionally  ufed  for  this  purpofe,  as  mentioned  in  Clafs  III* 
2.  i.  10.  And  children  fhould  have  no  cap  ft  ring  tied  under 

their 


i68  DISEASES  CLASS  II.  i.  2. 

their  chhls,  in  any  cough  or  difficulty  of  refpiration,  fince  if  the] 
ilip  down  in  their  bed  the  friction  of  the  night-cap  on  the  pil- 
low is  liable  to  draw  the  tape  or  ribbon  under  the  chin  too  tight, 
and  fuffocate  them.  After  the  patient  is  greatly  debilirated,  fc 
that  no  further  evacuation  can  be  admitted,  and  the  difficult: 
breathing  and  cough  continue,  I  have  given  four  or  five  drops 
of  tincture  of  opium,  that  is,  about  a  quarter  of  a  grain  of  folid 
opium,  with  great  advantage,  and  I  believe  in  feveral  cafes  I 
have  faved  the  patient.  A  greater  quantity  of  opium  in  this 
flate  of  debility  cannot  be  ufed  without  hazarding  the  life  of  the 
perfon.  This  fmall  quantity  of  an  opiate  mould  be  given  about 
{ix  in  the  evening,  or  before  the  accefs  of  the  evening  paroxyfrn, 
and  repeated  three  or  four  nights,  or  longer. 

There  is  a  peripneumony  with  weak  pulfe,  which  may  be 
termed  peripneumonia  inirritata,  as  defcribed  in  Seel:.  XXVII.  2. 
which  belongs  to  this  place.  See  alfo  Superficial  Peripneumo- 
ny, Clafs  II.  i.  3.  7. 

Peripneumonia  arthritica.  Gouty  peripneumony.  I  believe, 
that  there  exilts  a  peripneumony,  and  a  pleurify  which  owe  their 
inflammation  to  the  fympathy  of  thofe  membranes  with  fome 
other  parts  of  the  fyftem,  and  may  then  properly  be  termed 
rheumatic  or  gouty  peripneumony,  or  pleurify.  And  that  the 
coagulable  lymph  left  upon  the  inflamed  membranes  has  gener- 
ally been  owing  to  thefe  fympathetic  inflammations,  and  that  hy- 
drops  thoracis,  and  anafarca  pulmonum  are  generally  caufed  by 
gouty  affections  of  the  lungs,  or  rheumatic  affections  of  the  pleu- 
ra, and  not  by  the  more  common  idiopathic  inflammations  of 
thofe  membranes.  See  Oafs  I.  2.  3.  14.  and  Clafs  IV.  i.  2. 
1 6.  and  Clafs  IV.  i.  2.  9. 

Peripneumonia  tracbealis.  Croup.  The  croup  is  an  inflam- 
mation of  the  upper  part,  and  the  peripneumonia  of  the  lower 
part  of  the  fame  organ,  viz.  the  trachea  or  wind-pipe.  Sec 
Clafs  I.  1.3.  4.  But  as  the  inflammation  is  feldom,  I  believe, 
confined  to  the  upper  part  of  the  trachea  only,  but  exifts  at  the 
fame  time  in  other  parts  of  the  lungs  ;  and  as  no  inflammation  of 
the  tonfils  is  generally  perceptible,  the  uncouth  name  of  cynan- 
che  trachealis  fhould  be  changed  for  peripneumonia  trachealis. 

Dr.  Wichmann,  of  Hanover,  believes,  that  the  acute  afthma 
of  Millar,  or  hives,  has  been  confounded  with  the  angina  polypofn, 
or  croup,  which  has  occaiioned  the  great  difference  in  the  treat- 
ment recommended  by  authors  *,  as  the  difeafe  has  been  efteem- 
ed  inflammatory  by  fome,  and  fpafmodic  by  others. 

The  convulfive  afthma,  which  I  have  witneffed  in  one  child, 
was  readily  diftinguiftied  from  the  croup  ;  as  there  wasfimply  a 
great  exertion  in  breathing,  but  without  the  harih  found  which 

attends 


CLASS  II.  i.  2. 4.          OF  SENSATION.  1*9 

attends  the  infpirations  in  the  latter,  and  there  was  no  attendant 
fever ;  and  the  difeafe  was  cured  by  one  venefection,  and  a 
moderate  dofe  of  opium  after  the  venefe&ion.  See  afthma 
convulfivum.  Clafs  III.  i.  I.  10. 

A  conwtlfive  difficulty  of  refpiration  may  thus  be  eafily  dtf- 
tiriguifhed  from  the  croup  ;  as  in  the  former  the  patient  draws 
in  the  breath  eafily,  and  then  voluntarily  clofes  the  larynx,  and 
voluntarily  ufes  great  exertion  in  forcing  out  the  breath,  with 
defign  to  relieve  f$me  pain  by  this  violent  exertion,  as  in  parox» 
yfms  of  eptlepfy. 

On  the  contrary,  in  the  croup  the  breath  is  eafily  expired, 
but  the  infpirations  are  attended  with  the  utmoft  difficulty. 
This  difficulty  of  infpiration  may  be  feen  by  viewing  the  region 
of  the  ftornach  i  as  when  the  child  raifes  the  fternum  for  the 
purpofe  of  drawing  in  its  breath,  the  preflure  of  the  atmof- 
phere  on  the  pit  of  the  ftomach  prefles  the  diaphragm  upwards, 
and  makes  a  fudden  and  great  hollow  in  the  fcrobiculus  cordis^ 
This  difficulty  of  infpiration,  and  not  of  expiration,  is  alfo  known 
by  the  harfli  found ,  which  only  attends  the  infpiration. 

This  difficulty  of  infpiration  may  in  part  be  owing  to  this  cir- 
cumftance.  In  directing  thofe  children  who  have  died  of  the 
croup,  I  believe  the  upper  part  of  the  adherent  coagulable  lymph, 
or  indurated  mucus,  formed  within  the  trachea,  is  found  to  be- 
come loofe,  and  to  feparate  from  the  upper  part  of  the  trachea 
before  the  lower  part  of  that  adhefive  membranous  cruft  begins 
to  feparate,  and  hence  the  loofe  upper  part  at  the  time  of  infpira- 
tion is  bent  downwards  into  the  trachea,  and  thus  becomes  dou- 
ble, and  obftrucb  the  paflage  ;  but  this  duplicature  of  it  does 
not  happen  in  expiration.  See  Tranfact.  of  a  Society,  Vol.  II. 
Account  of  Croup,  by  Henry  Ram  ley,  cafe  the  8th.  Might  not 
this  be  prevented  from  being  fatal,  by  an  aperture  into  the  wind- 
pipe beneath  the  larynx  ? 

I  have  very  lately  feen  a  mod  diftinct  cafe  of  this  peripneu- 
monia  trachealis,  or  croup.  The  child,  about  ten  months  old, 
had  great  difficulty  in  drawing  in  its  breath,  with  much  noife  ; 
but  had  much  lefs  difficulty  in  its  expiration,  with  little  or  gener- 
ally no  found.  On  obferving  its  naked  cheft,  the  fternum,  or 
breaft-bone,  was  feen  to  be  raifed  with  great  force  -,  and  then  the 
diaphragm,  and  the  bowels  under  it,  rofe  haftily  up  into  the  low- 
er part  of  the  cavity  of  the  cheft  ;  and  the  air  ruined  with  diffi- 
culty, and  with  great  found,  through  the  contracted  larynx  into 
the  upper  part  of  the  cheft  ;  both  thefe  effects  were  evidently 
owing  to  the  prelTure  of  the  atmofphere,  to  fupply  the  vacuity, 
which  muft  otherwife  fucceed  the  forcibly  railing  of  the  fternum. 
Why  the  difficulty  of  infpiring  was  fo  much  greater  than 
VOL.  II.  Y  of 


173  DISEASES  CLASS  II.  i.  2.  4> 

of  expiring,  requires  to  be  further  explained.  During  irifpira- 
tion,  the  preflure  of  the  atmofphere,  when  the  cavity  of  the 
cheft  is  enlarged  by  raifing  the  fternum,  and  depreffing  the  dia- 
phragm, a£ls  upon  the  external  part  of  the  larynx,  as  v/ell  as  on 
the  aperture  of  it,  and  thus  contracts  it,  and  affifts  the  difeafe  j 
whereas  in  expiration  there  is  no  increafe  of  atmofpheric  pref- 
fure  on  the  outfide  of  the  larynx,  or  trachea,  to  prevent  the  ex- 
clufion  of  the  air.  In  the  fame  manner,  if  a  flexible  pipe  of  foft 
leather  was  extended  upwards  a  few  inches  through  the  bottom 
of  a  bucket  of  water,  but  very  little  of  the  water  could  be  dif- 
charged  by  it ;  as  the  preiTure  on  its  fides  would  foon  comprefs 
the  pipe,  and  thus  flop  np  its  mouth. 

After  repeated  venefection,  and  a  cathartic  of  calomel,  a  blifl 
ter  was  applied  oh  each  fide  of  the  larynx,  and  the  difficulty  of 
breathing  became  greatly  relieved  ;  and  though  the  child  had  in- 
tervals of  eafier  refpiration,  and  without  noiie,  yet  it  died  on  the 
fucceeding  day. 

Where  the  difficulty  of  breathing  is  very  urgent  in  the  croup, 
bronchotomy  is  recommended  by  Mr.  Field.  ,  Memoirs  of  a 
Medical  Society,  London,  1773,  Vol.  IV. 

After  repeated  venefedion,  and  cathartics,  perhaps  a  drop  or 
two  drops  of  tinfture  of  opium,  about  fix  in  the  evening,  might 
be  of  ufe  to  prevent  the  return  of  the  evening  paroxyfm,  and  this 
efpecially  if  the  difficulty  of  refpiration  has  an  interval  or  remif- 
fion,  as  mentioned  below. 

A  ftrong  decoclion  of  feneca  root  is  recommended  by  Dr. 
Archer,  of  America.  He  boils  half  an  ounce  of  the  root,  from 
eight  ounces  of  water  to  four,  and  gives  a  tea-fpoonful  every 
hour  or  half  hour,  fo  as  to  produce  vomiting  or  purging,  and 
then  gives  it  in  fmaller  quantities.  He  alfo  rubs  mercurial 
ointment  about  the  throat,  and  ufes  calomel  internally,  fo  as  to 
afFe£t  the  glands  of  the  throat  as  quickly  as  poffible,  when  the 
difeafe  is  more  advanced,  and  the  difficulty  of  breathing  with 
harm  and  thrill  infpiration  is  more  urgent.  Medical  and  Phyfic- 
al  Journal,  No.  I.  p.  83.  Asa  decodtion  of  feneca  root  partic- 
ulary  ftimulates  fome  parts  of  the  throat,  occafioning  a  difagreea- 
ble  fenfation  in  it,  it  may  in  fome  cafes  contribute  to  loolen  or 
difcharge  the  adheiive  coagulable  lymph,  which  has  been  fecre- 
ted  on  the  inflamed  membrane  of  the  wind-pipe,  and  occafioris 
the  difficulty  of  infpiration  by  contracting  its  aperture  ;  and 
may  therefore  be  worth  trial  after  repeated  venefecStion,  and 
cathartics,  and  blifters  on  each  fide  of  the  throat. 

Dr.  Wichmcmn  of  Hanover,  above  mentioned,  aiTcrts,  that  in 
the  croup  the  difeafe  continues  regularly  to  increafe,  from  the 
commencement  of  it,  without  intervals  of  relief  from  the  great 

difficult'^ 


-•5  II.  1.2.5-          OF  SENSATION. 

iilty  of  breathing;  and   gives   this    as  a  criterion  to  diftin- 

;  the  angina  polypola  from  the  afthma  acutum.     Annals  of 

Medicine,  Vol.  I.     But  in  the  cafes  of  true  croup,  peripneumo- 

•rachealis,  I  have  ken  with  furprife  the  difficulty  of  refpira- 
tion  to  ceafe  for  a  time,  and  return  again  with  unabated  violence. 
Thefe  remiiTions  of  the  diilicult  reiptration  are  alfo  mentioned 
by  Dr.  Ferriar,  who  then  terms  it  a  fpurious  croup,  but  which 
I  fufpecl:  to  be  owing  fimply  to  the  following  circumflances. 

In  a  common  catarrh,  when  the  raucous  membrane  of  the 
noftrils  is  much  inflamed,  it  becomes  fo  thickened  as  totally  to 
prevent  refpiration  through  them  ;  yet  on  fuddenly  warming  the 
Ikin,  by  drinking  tea  or  by  a  fire,  and  fometimes  l>y  only  cooling 
the  membrane  of  the  noftrils  by  going  into  the  cold  air,  the  fwel- 
Kng  of  this  membrane  will  fuddenly  fubfide,  fo  as  to  permit  the 
air  to  pafs  through  quite  eafily  for  a  time,  as  explained  in  ca- 
tarrhus  calidus.  Clafs  I.  i.  2.  7.  The  fame  circumftance  may 
occur  to  the  inflammation  of  the  membrane,  which  lines  the  up- 
per part  of  the  trachea,  or  it  may  happen  from  the  doubling  of 
the  loofencd  upper  part  of  the  adhefive  mucus. 

M.  M.  Frequent  bleeding  by  the  lancet  or  leeches.  A  few- 
grains  of  calomel.  Seneca.  Blifters  about  the  throat.  An 
opiate  in  fmall  quantity  at  night  after  previous  evacuations. 
Mercurial  ointment.  Warm  bath.  Breathing  over  the  fteam 
of  warm  water,  with  or  without  volatile  alkali,  or  ether,  or  vine- 
gar. Particular  attention  fhould  be  ufed  to  keep  the  child  raifed 
high  in  bed.  Might  the  fkin  be  kept  agreeably  warm,  and  at 
the  fame  time  might  quite  cold  air  be  breathed  through  a  tube 
coming  from  without,  through  a  broken  window,  or  hole  in  a 
door  ?  Or  might  the  child  be  carried  out  into  the  cold  air  very 
warmly  clad  ?  If  a  folution  of  fublimate  could  be  fafely  ufed, 
as  in  gonorrhoea,  Clafs  II.  1.5.  I  ? 

After  evacuation  by  copious  venefeclion,  might  not  the  fre- 
quent application  of  ether  externally  to  the  throat  be  ferviceable  ? 
And  where  there  occur  intervals  of  eafy  refpiration,  might  not 
breathing  over  the  duft  of  powdered  Peruvian  bark  prevent  a  re- 
turn of  the  thickening  of  the  membrane,  as  defcribed  in  Clafs  II. 
..  6.  7. 

5.  Pleuritis.  Pleurify.  Inflammation  of  the  pleura,  with 
liard  pulfe,  pain  chiefly  of  the  fide,  pungent,  particularly  increaf- 
ed  during  infpiration  ;  lying  on  either  fide  uneafy,  the  cough 
very  painful,  dry  at  the  beginning, afterwards  moift, often  bloody. 

One  caufe  of  pleurify  is  probably  a  previous  adhefion  of  the 
lungs  to  a  part  of  the  pleura,  which  envelopes  them.  This  in 
many  cafes  has  been  produced  in  infancy,  by  flittering  children 
to  lie  too  long  on  one  (ide.  Or  by  placing  them  uniformly  on  one 

fidp 


172  DISEASES  CLASS  II.  i.  2. 

fide  of  a  fire,  or  window,  to  which  they  will  be  liable  always  t 
bend  themfelves. 

When  matter  is  produced  during  peripneumony  or  pleurify 
Jn  one  fide  of  the  cheft,  fo  long  as  it  is  a  concealed  vomiea,  the 
fever  continues,  if  the  difeafe  be  great,  for  many  weeks,  and  even 
months ;  and  requires  occafional  venefe&ion,  till  the  patient 
•finks  under  the  inflammatory  or  fenfitiye  irritated  fever.  But  if 
air  be  admitted,  by  a  part  of  the  abfcefs  opening  itfelf  a  way  in- 
to the  air-veffels  of  the  lungs,  a  heclic  fever,  with  colliquative 
fweats  or  diarrhoea,  fupervenes,  and  frequently  deftroys  the  pa- 
tient ;  or  the  abfcefs  heals,  the  lungs  adhering  to  the  pleura. 
See  pleurodyne  rheumatica.  Clafs  IV.  1.2.  16. 

M.  M.  The  lancet  muft  be  ufed  copioufly,  and  repeated  as 
often  as  the  pain  and  difficult  refpiration  increafe.  A  blifter  on 
the  pained  part.  Antimonial  preparations.  Diluents.  Cool 
air.  Do  neutral  falts  increafe  the  tendency  to  cough  ?  PedU 
luvium  or  femicupium  frequently  repeated. 

6.  Dlaphragmitis.  Inflammation  of  the  diaphragm.  Pain, 
round  the  lower  ribs  as  if  girt  with  a  cord.  DiiHcult  refpira- 
tion performed  only  by  elevating  the  ribs  and  in  an  erecl:  pof- 
ture.  The  corners  of  the  mouth  frequently  retracted  into  a  dik 
agreeable  fmiJe,  called  rifus  Sardoriicus. 

Thofe  animals,  which  are  furnifhed  with  clavicles,  or  collar^ 
bones,  not  only  ufe  their  foremoft  feet  as  hands,  as  men,  mon- 
keys, cats,  mice,  fquirrels,  &c.  but  elevate  their  ribs  in  refpira- 
tion as  well  as  deprefs  the  diaphragm  for  the  purpofe  of  enlarg- 
ing the  cavity  of  the  cheft.  Hence  an  inflammation  of  the  dia- 
phragm is  fudden  death  to  thofe  animals,  as  horfes  and  dogs, 
which  can  only  breathe  by  deprefling  the  diaphragm  ;  and  is  I 
fuppofe  the  caufe  of  the  fudden  death  of  horfes  that  are  over-, 
worked  ;  whereas,  in  the  human  animal,  when  the  diaphragm 
is  inflamed,  fo  as  to  render  its  motions  impoijible  from  the  pain 
they  occafion,  refpiration  can  be  carried  on,  though  in  a  lefs  per- 
fe£t  manner,  by  £he  intercoftal  mufcles  in  the  elevation  of  the 
ribs.  In  pleurify  the  ribs  are  kept  motionlefs,  and  the  refpira- 
tion is  performed  by  the  diaphragm,  as  may  be  readily  feen  on 
infpe<£\ing  the  naked  cheft,  and  which  is  generally  a  bad  fymp- 
tom  ;  in  the  diaphragmitis  the  ribs  are  alternately  elevated,  an4 
deprefled,  but  the  lower  part  of  the  belly  is  not  feen  to  move. 

M.  M.  As  in  pleurify  and  peripneumony.  When  the  pa- 
tient becomes  delirious,  and  fmiles  difagreeably  by  intervals,  and 
is  become  fo  weak,  that  evacuations  by  the  lancet  could  be  ufed 
no  further,  and  I  have  almoft  defpaired  of  my  patient,  I  have 
found  in  two  or  three  inftances,  that  about  five  or  fix  drops  of 
jincl:.  thebaic.  given  an  hour  before  the  evening  exacerbation, 

have 


CLASS  II.  i.  2.  7,        OF  SENSATION.  173 

have  had  the  happiefl  effefr,  and  cured  the  patient  in  this  cafe, 
as  well  as  in  common  peripneumony  •,  it  mult  be  repeated  t\vo 
or  three  evenings,  lee  Clafs  II.  I.  2.  4.  as  the  exacerbation  of 
the  fever,  and  difficult  refpiration,  and  delirium,  generally  in- 
creafe  towards  night. 

The  ftimulus  of  this  fmall  quantity  of  opium  on  a  patient 
previoufly  fo  much  debilitated,  acts  by  increafing  the  exertion  of 
the  abforbent  veflels,  in  the  fame  manner  as  a  folution  of  opium, 
or  any  other  ftimulant,  pui  on  an  inflamed  eye  after  the  veflels 
are  previoufly  emptied  by  evacuations,  fhmulates  the  abforbent 
fyftem,  fo  as  to  caufe  the  remaining  new  veflels  to  be  immediate- 
ly reabforbed.  Which  fame  ftimulants  would  have  increafed 
the  inflammation,  if  they  had  been  applied  before  the  evacua- 
tions. See  Ciafs  II.  i.  2.  2.  Sea.  XXXIII.  3.  I.  When  the 
fanguiferous  fyftem  is  full  of  blood,  the  abforbents  cannot  act  fo 
powerfully,  as  the  progrefs  of  their  contents  is  oppofed  by  the 
previous  f  ulnefs  of  the  blood-veflels  ;  whence  ftimulants  in  that 
cafe  increafe  the  action  of  the  fecerning  fyftem  more  than  of  the 
abforbent  one  ;  but  after  copious  evacuation  this  refiftance  to 
the  progrefs  of  the  abibrbed  fluids  is  removed  ;  and  when  ftim- 
ulants are  then  applied,  they  increafe  the  action  of  the  abforb- 
ent fyitern  more  than  that  of  the  fecerning  one.  Hence  opium 
given  in  the  commencement  of  inflammatory  difeafes  de- 
ftroys  the  patient  ;  and  cures  them,  if  given  in  very  fmall  .dofes 
at  the  end  of  inflammatory  difeafes. 

7.  Carditis.     Inflammation  of  the  heart  is  attended  with  un- 
equal intermitting  pulfe,  palpitation,  pain  in  the  middle  of  the 
ftornum,  and  conftant   vomiting.     It  cannot  certainly  be  diltin- 
guiihed  from  peripneumony,  and  is  perhaps  always  combined 
with  it. 

8.  Peritonitis.     Inflammation  of  the  peritonaeum  is  known 
jby  pain  all  over  the  abdomen,  which  is  increafed  on  erecting  the 
body.     It  has  probably  moft  frequently  a  rheumatic  origin.    See 
Clafs  II.  i.  2.  17. 

9.  Mef enteritis.     Inflammation  of  the  mefentery  is  attended 
with  pains  lijie  colic,  and  with  curdled   or  chyle-like  ftools.     It 
is  a  very  frequent  and   dangerous  difeafe,  as  the  production  of 
matter  more  readily  takes  place   in  it  than  in  any  other  vifcus. 
The  confequence  of  which,  after  a  hard  labour,  is  probably  the 
puerperal  fever,  and  in  fcrofulous  habits  a  fatal  purulent  fever, 
or  hopekfs  confumption. 

M.  M.  VenefecHon.     Warm  bath.     Emollient  clyfters. 

10.  Gaftritis.     In  inflammation  of  the   ftomach   die  pulfe  is 
generally  foft,  probably  occafioned  by  the  iicknefi  which  attends 

it. 


174  DISEASES  CLASS  II.  r.  2.  it, 

it.  The  pain  and  heat  of  the  ftomach  are  Jncreafed  by  what- 
ever is  fwallowed,  with  immediate  rejection  of  it.  Hiccough. 

This  difeafe  may  be  occafioned  by  acrid  or  indigeftible  mat- 
ters taken  into  the  ftomach,  which  may  chemically  or  mechanical* 
ly  injure  its  interior  coat.  There  is  however  a  (lighter  fpecies  of 
inflammation  of  this  vifcus,  and  perhaps  of  all  others,  which  is 
unattended  by  much  fever  ;  and  which  is  fometimes  induced  by 
drinking  cold  water,  or  eating  cold  infipid  food,  as  raw  turnips, 
when  the  perfori  has  been  much  heated  and  fatigued  by  exercife. 
For  when  the  fenforial  power  has  been  diminifhed  by  great  ex- 
ertion, and  the  ftomach  has  become  lefs  irritable  by  having  been 
previoufly  ftimulated  by  much  heat,  it  fooner  becomes  quiefcent 
by  the  application  of  cold.  In  confequence  of  this  flight  inflam- 
mation of  the  ftomach  an  eruption  of  the  face  frequently  enfues 
by  the  fenfitive  aflbciation  of  this  vifcus  with  the  (kin,  which  is 
called  a  furfeit.  See  ClafsIV.  i.  a.  13.  and  II.  i.  4.  6.  and  II. 
1.3.  19. 

M.  M.  Venefe&ion.  Warm  bath.  Blifter.  Anodyne  clyf- 
ters.  Almond  foap.  See  Clafs  II.  1.3.  17. 

IT.  Enteritis.  Inflammation  of  the  bowels  is  often  attended 
with  foft  pulfe,  probably  owing  to  the  concomitant  ficknefs  ; 
which  prevents  fometimes  the  early  ufe  of  the  lancet,  to  the  de- 
ftrudion  of  the  patient.  At  other  times  it  is  attended  with 
ftrong  and  full  pulfe  like  other  inflammations  of  internal  mem- 
brrtnes.  Can  the  feat  of  the  difeafe  being  higher  or  lower  in 
the  inteftinal  canal,  that  is,  above  or  below  the  valve  of  the  co- 
lon, produce  this  difference  of  pulfe  by  the  greater  fympathy  of 
one  part  of  the  bowels  with  the  ftomach  than  another  ?  In  en- 
teritis with  ftrong  pulfe  the  pain  is  great  about  the  navel,  with 
vomiting,  and  the  greateft  difficulty  in  procuring  a  ftool.  In  the 
other,  the  pain  and  fever  are  lefs,  without  vomiting,  and  with 
diarrhoea.  Whence  it  appears,  that  the  enteritis  with  hard 
quick  pulfe  differs  from  ileus,  defcribed  in  Clafs  I.  3.  i.  6.  only 
in  the  exiftence  of  fever  in  the  former  and  not  in  the  latter,  the 
other  fymptoms  generally  correfponding  ;  and,  fecotidly,  that 
the  enteritis  with  fofter  quick  pulfe,  differs  from  the  cholera  de- 
fcribed in  Clafs  I.  3.  i.  5.  only  in  the  exiftence  of  fever  in  the 
former,  and  not  in  the  latter,  the  other  fymptoms  being  in  gen- 
eral fimilar.  See  Clafs  II.  i.  3.  20. 

Inflammation  of  the  bowels  fometimes  is  owing  to  extraneous 
indigeftible  fubftances,  as  plum-ftones,  efpecially  of  the  dama- 
fin,  which  has  fharp  ends.  Sometimes  to  an  introfufception  of 
one  part  of  the  inteftine  into  another,  and  very  frequently  to  a 
ftrangulated  hernia  or  rupture.  In  refpec~l  to  the  firft,  1  knew 
an  initance  where  a  damafin  {tone,  after  a  long  period  of  time, 

found 


CLASS  II.  i.  2.  12.       OF  SENSATION.  175 

found  its  way  out  of  the  body  near  the  groin.  I  knew  another 
child,  who  vomited  fome  damafm  (tones,  which  had  lain  for  near 
twenty  hours,  and  given  great  pain  about  the  navel,  by  the  exhi- 
bition of  an  emetic  given  in  repeated  dofes  for  about  an  hour. 
The  fwallowing  of  plum-ftones  in  large  quantities,  and  even  of 
cherry- ftones,  is  annually  fatal  to  many  children.  In  refpecfc 
to  the  introfufception  and  hernia,  fee  lieus,  Clafs  I.  3.  i.  6. 

M.  M.  Repeated  venefedtion.  Calomel  from  ten  to  twen- 
ty grains  given  in  fmall  pills  as  in  ileus ;  thefe  means  ufed  early 
in  the  difeafe  generally  fucceed.  After  thefe  evacuations  a  blif- 
ter  contributes  to  Hop  the  vomiting.  Warm  bath.  Crude  mercu- 
ry. Aloes  one  grain-pill  every  hour  will  frequently  (lay  in  the 
flomach.  Glauber's  fait  diUblved  in  pepper-mint  water  given  by 
repeated  fpoonfuls. 

When  the  patient  is  much  reduced,  opium  in  very  finall  do- 
fes may  be  given,  as  a  quarter  of  a  grain>as  recommended  in  pleu- 
rify.  If  the  pain  fuddenly  ceafes,and  the  patient  continues  to  vom- 
it up  whatever  is  given  him,  it  is  generally  fatal;  as  it  indicates, 
that  a  mortification  of  the  bowel  is  already  formed.  Some  au- 
thors have  advifed  to  join  cathartic  medicines  with  an  opiate  in 
inflammation  of  the  bowels,  as  recommended  in  colica  faturnina. 
This  may  fucceed  in  llighter  cafes,  but  is  a  dangerous  practice 
in  gc  ;ice}  if  the  obftruction  be  not  removed  by  the  e- 

vacuation,  the  itimulus  of  the  opium  is  liable  to  increafe  the 
action  of  die  veflels,  and  produce  mortification  of  the  bowel,  as 
I  think  I  have  fcen  more  than  once.  Mercury  injected  by  the 
anus,  or  water  by  a  forcing-pump.  See  Ileus  I.  3.  i.  6. 

12.  Hepatitis.  Inflammation  of  the  liver  is  attended  with 
Itrong  quick  pulfe  j  tenfion  and  pain  of  the  right  fide  ;  often 
pungent  as  in  pleurify,  oftener  dull.  A  pain  is  laid  to  afreet 
the  clavicle,  and  top  of  the  right  fhoulder  ;  with  difficulty  in  ly- 
ing on  the  left  fide  ;  difficult  refpiration  ;  dry  cough  j  vomiting ; 
hiccough. 

There  is  another  hepatitis  mentioned  by  authors,  in  which  the 
fever,  and  other  fymptoms,  are  wanting,  or  are  lefs  violent ;  as 
defcribed  in  Clafs  II.  i.  4.  n.  and  which  is  probably  fome- 
times  relieved  by  eruptions  of  the  face  -,  as  in  thofe  who  are  ha- 
bituated to  the  intemperate  ufe  of  fermented  liquors. 

M.  M.  Hepatic  inflammation  is  very  liable  to  terminate  in 
fuppuration,  and  the  patient  is  deftroyed  by  the  continuance  of 
a  fever  with  lizy  blood,  but  without  night  fweats,  or  diarrhoea, 
as  in  other  unopened  abfceifes.  Whence  copious  and  repealed 
venefeclion  is  required  early  in  the  difeafe,  with  repeated  dofes 
of  calomel,  and  cathartics.  Warm  bath.  Towards  the  end  of 
the  difeafe  fmall  dofes  of  opium  before  the  evening  paroxyims, 

and 


17$  DISEASES  CLASS  II. . r.  2.  13, 

and  Jaftly  the  Peruvian  bark,  and  chalybeate  wine,  at  firft  in 
finall  dofes,  as  20  drops  twice  a  day,  and  afterwards,  if  neceflii- 
ry,  in  larger.  See  Art.  IV.  2.  6. 

Towards  the  end  of  hepatitis,  after  repeated  venefe£lion  and 
catharfis,  an  eruption  fometimes  appears  round  the  lips,  which 
is  generally  a  falutary  fymptom  :  and  the  decoction  of  Peruvian 
bark  given  at  this  time,  in  the  quantity  of  about  two  ounces  ev- 
ery fix  hours,  removes  the  remaining  inflammatory  tendency, 
and  cures  in  a  day  or  two. 

Mrs.  C.  a  lady  in  the  laft  month  of  her  pregnancy,  was  feiz- 
ed  with  violent  hepatiti «,  with  fymptoms  both  of  peripneumony 
and  of  pleurify,  for  it  felclom  happens  in  violent  inflammations, 
that  one  vifcus  alone  is  affected  ;  (he  wanted  then  about  a  fort- 
night of  her  delivery,  and  after  frequent  venefeftion,  with  gen- 
tle cathartics,  with  fomentation  or  warm  bath,  fhe  recovered  and 
was  fofely  delivered,  and  both  herfelf  and  child  did  well.  Rheu- 
matic and  eruptive  fevers  are  more  liable  to  induce  abortion. 

13.  Splenitis.     Inflammation  of  the  fpleen  commences  with 
tenfion,  heat,  and  tumour  of  the  left  fide,  and  with  pain,  which 
is  icreafed  by  pretTure.     A  cafe  is  defcribed  in  Clafs  I.  2.  3.  18. 
where  a  tumid  fpleen,  attended  with  fever,  terminated  in  fcir- 
rhus  of  that  vifcus. 

14.  Nephritis.     Inflammation  of  the  kidney  feems  to  be  of 
two  kinds  ;  each  of  them  attended  with  different  fymptoms,  and 
different  modes  of  termination.     One  of  them  I  fuppofe  to  be 
an  inflammation  of  the  external    membrane  of  the  kidney,  ari- 
fmg  from  general  caufes  of  inflammation,  and  accompanied  with 
pain  in  the  loins  without  vomiting  ;  and  the  other  to  confift  in  an 
inflammation  of  the  interior  parts  of  the  kidney,  occafioned  by 
the  ftimulus  of  gravel  in  the  pelvis  of  it,  which  is  attended  with 
perpetual  vomiting,  with  pain  along  the  courfe  of  the  ureter,  and 
retraction  of  the  teflis  on  that  fide,  or  numbnefs  of  the  thigh. 

The  former  of  the fe  kinds  of  nephritis  is  diftinguifhed  from 
lumbago  by  its  fituation  being  more  exactly  on  the  region  of  the 
kidney,  and  by  its  not  being  extended  beyond  that  part ;  after 
three  or  four  days  I  believe  this  inflammation  is  liable  to  change 
place ;  and  that  a  herpes  or  eryfipelas,  called  zona,  or  (hingles, 
breaks  out  about  the  loins  in  its  (lead  j  at  other  times  it  is  cured 
by  a  cathartic  with  calomel,  with  or  without  previous  venefec- 
tion. 

The  other  kind  of  nephritis,  or  inflammation  of  the  interior 
part  of  the  kidney,  generally  arifes  from  the  pain  occafioned  by 
the  ftimulus  of  a  ftone  entering  the  ureter  from  the  pelvis  of  the 
kidney  ;  and  which  ceafes  when  the  ftone  is  protruded  forwards 
into  the  bladder  j  or  when  it  is  returned  into  the  pelvis  of  the 

kidney 


CLASS  IL  i.  2.  i$.       OF  SENSATION.  177 

kidney  by  the  retrograde  action  of  the1  ureter.  The  kidney  is 
neverthelefs  inflamed  more  frequently,  though  in  a  lefs  degree, 
from  other  caufes ;  efpecially  from  the  intemperate  ingurgitation 
cf  ale,  or  other  fermented  or  fpirituous  liquors.  This  lefs  de- 
gree of  inflammation  is  the  caufe  of  gravel,  as  that  before  men- 
tioned is  the  effect  of  it.  The  mucus  fecreted  to  lubricate  the 
internal  furface  of  the  uriniferous  tubes  of  the  kidney  becomes 
fecreted  in  greater  quantity,  when  thefe  veflels  are  inflamed  ;  and, 
as  the  correipondent  abforbent  veflels  aft  more  energetically  at 
the  fame  time,  the  abforption  of  its  more  fluid  parts  is  more 
powerfully  affected  ;  on  both  thefe  accounts  the  mucus  becomes 
both  changed  in  quality  and  more  indurated.  And  in  this  man- 
ner ftones  are  produced  on  almoft  every  mucous  membrane  of 
the  body  •,  as  in  the  lungs,  bowels*  and  even  in  the  pericardium, 
as  fome  writers  have  affirmed.  See  Clafs  I.  i.  3.  9. 

M.  M.  Venefjeftion.  Ten  grains  of  calomel  given  in  fmall 
pills,  then  infufion  of  fena  with  oil.  Warm  bath.  Then  opi- 
um a  grain  and  half.  See  Clafs  I.  I.  3.  9.  for  a  further  ac- 
count of  the  method  of  cure. 

i^.CyJlitis.  Inflammation  of  the  bladder  is  attended  with 
tumor  and  pain  of  the  lower  part  of  the  belly ;  with  difficult 
and  painful  micturition  ;  and  tenefmus.  It  generally  is  produ- 
ced by  the  exiftence  of  a  large  ftone  in  the  bladder,  when  in  a 
great  degree  ;  or  is  produced  by  -common  caufes,  when  in  a 
ilighter  degree. 

The  ftone  in  the  bladder  is  generally  formed  in  the  kidney, 
and  pafling  down  the  ureter  into  the  bladder  becomes  there  grad- 
ually increafed  in  fize  ;  and  this  moft  frequently  by  the  appofi- 
tion  of  concentric  fpheres,  as  may  be  feen  by  few  ing  fome  of 
the  harder  calculi  through  the  middle,  and  polifhing  one  furface. 
Thefe  new  concretions  fuperinduced  on  the  nucleus,  which  de- 
fcended  from  the  kidney,  as  defcribed  in  Clafs  I.  i.  3.  9.  and  in 
the  preceding  article  of  this  genus,  is  not  owing  to  the  micro- 
cofmic  fait,  which  is  often  feen  to  adhere  to  the  fides  of  cham- 
ber-pots, as  this  is  foluble  in  warm  water,  but  to  the  mucus  of 
the  bladder,  as  it  rolls  along  the  internal  furface  of  it.  Now 
when  the  bladder  is  (lightly  inflamed,  this  mucus  of  its  internal 
furface  is  fecreted  in  greater  quantity,  and  is  more  indurated 
by  the  abforption  of  its  more  liquid  part  at  the  inftant  of  fecre- 
tion,  as  explained  in  Clafs  I.  i.  3.  9.  and  II.  i.  2.  14.  and 
thus  the  ftiniuius  and  pain  of  a  ftone  in  the  bladder  contribute 
to  its  enlargement  by  inflaming  the  interior  coat  of  it. 

M.  M.  Venefec\ion.  Warm  bath.  Diluents.  Anodyne 
clyfters.  See  Cfcfs  I.  i.  3.  9. 

1 6.  Hyjleritis.     Inflammation  of  the  womb  is  accompanied 

VOL.  II.  Z 


278  DISEASES  CLASS  IL  2.  i.  17. 

with  heat,  tenfion,  tumour,  and  pain  of  the  lower  belly.  The 
os  uteri  painful  to  the  touch.  Vomiting.  This  difeafe  is  gen- 
erally produced  by  improper  management  in  the  delivery  of 
pregnant  women.  I  knew  an  unfortunate  cafe,  where  the  pla- 
centa was  left  till  the  next  day  ;  and  then  an  unfkilful  accouch- 
eur introduced  his  hand,  and  forcibly  tore  it  away  ;  the  confe- 
quence  was  a  moft  violent  inflammatory  fever,  with  hard  throb, 
bing  pulfe,  great  pain,  very  fizy  blood,  and  the  death  of  the  pa- 
tient. Some  accoucheurs  have  had  a  practice  of  introducing 
their  hand  into  the  uterus  immediately  after  the  birth  of  the 
child,  to  take  away  the  placenta  j  which  they  faid  was  to  fave 
time.  Many  women  I  believe  have  been  victims  to  this  unnat- 
ural practice. 

Others  have  received  injury,  where  inflammation  has  been 
beginning,  by  the  univerfal  practice  of  giving  a  large  dofe  of  o- 
pium  immediately  on  delivery,  without  any  indication  of  its 
propriety  ;  which,  though  a  proper  and  ufeful  medicine,  where 
the  patient  is  too  feeble,  when  given  in  a  fmall  dofe,  as  10 
drops  of  tincture  of  opium,  or  half  a  grain  of  folid  opium,  muffc 
do  a  proportionate  injury,  when  it  is  given  improperly ;  and  as 
delivery  is  a  natural  procefs,  it  is  certainly  more  wife  to  give  no 
medicines,  except  there  be  fome  morbid  fymptom,  which  re- 
quires it ;  and  which  has  only  been  introduced  into  cuftom  by 
the  ill-employed  activity  of  the  priefts  or  prieftefles  of  LUCINA  ; 
like  the  concomitant  nonfenfe  of  cramming  rue  or  rhubarb  into 
the  mouth  of  the  unfortunate  young  ftranger,  who  is  thus  foon 
made  to  experience  the  evils  of  life.  See  Clafs  II.  I.  I.  12. 
and  I.  i.  2.  5.  Juft  fo  fome  over-wife  beldames  force  young 
ducks  and  turkeys,  as  foon  as  they  are  hatched,  to  fwallow  a 
pepper  corn. 

M.  M.  Venefection  repeatedly ;  diluents  ;  fomentation ;  the 
patient  mould  be  frequently  railed  up  in  bed  for  a  fhort  time, 
to  give  opportunity  of  difcharge  to  the  putrid  lochia ;  mucilag- 
inous clyfters.  See  Febris  Puerpera. 

17.  Lumbago  fenfitiva.  Senfitive  lumbago.  When  the  exten- 
five  membranes,  or  ligaments,  which  cover  the  mufcles  of  the 
back  are  torpid,  as  in  the  cold  paroxyfm  of  ague,  they  are  attend- 
ed with  pain  in  confequence  of  the  inaction  of  the  veflels,  which 
compofe  them.  When  this  inaction  continues  without  a  confe- 
vjuent  renewal  or  increafe  of  activity,  the  difeafe  becomes  chron- 
ical, and  forms  the  lumbago  frigida,  or  irritativa  defcribed  in 
Clafs  I.  2.  ,4.  1 6.  But  when  this  cold  fit  or  torpor  of  thefe 
membranes,  or  ligaments  or  mufcles  of  the  back,  is  Succeeded  by 
a  hot  fit,  and  confequent  inflammation,  a  violent  inflammatory 
fever,  with  great  pain,  occurs,  preventing  the  erect  pofture  of 

the 


CLASS  II.  i.  2.  1 8.       OF  SENSATION.  179 

the  body,  and  the  affected  part  is  liable  to  fuppurate,  in  which 
cafe  a  very  dangerous  ulcer  is  formed,  and  a  part  of  one  of  the 
vertebrae  is  generally  found  carious, and  the  patient  finks  after  a 
long  time  under  the  hectic  fever  occafioned  by  the  aerated  or 
oxygenated  matter. 

This  difeafe  bears  no  greater  analogy  to  rheumatifm  than  the 
inflammation  of  the  pleura,  or  any  other  membranous  inflam- 
mation 5  and  has  therefore  unjuftly  been  arranged  under  that 
name.  It  is  diftinguiflied  from  nephritis,  as  it  is  feldom  attend- 
ed with  vomiting,  I  fuppofe  never,  except  the  ureter  happens 
to  be  inflamed  at  the  fame  time. 

The  pain  fometimes  extends  on  the  outfide  of  the  thigh 
from  the  hip  to  the  ankle,  heel,  or  toes,  and  is  then  called  fci- 
atica  ;  and  has  been  thought  to  confift  in  an  inflammation  of  the 
theca,  or  covering  of  the  fciatic  nerve,  as  the  pain  fometimes  fo 
exactly  attends  the  principal  branches  of  that  nerve.  See  Clafs 
I.  2.  4.  15.  16. 

M.  M.  Venefection  repeatedly  ;  calomel ;  gentle  cathartics ; 
diluents ;  warm  bath ;  poultice  on  the  back,  confirming  of  camo- 
mile flowers,  turpentine,  foap,  and  opium  j  a  burgundy-pitch 
plafler.  A  debility  of  the  inferior  limbs  from  the  torpor  of  the 
mufcles,  which  had  previoufly  been  too  much  excited,  frequent- 
ly occurs  at  the  end  of  this  difeafe  ;  in  this  cafe  electricity,  and 
iffues  on  each  fide  of  the  lumbar  vertebra,  are  recommended.  See 
Clafs  I.  2.  4.  1 6. 

1 8.  Ifchias.  The  ifchias  confifts  of  inflammatory  fever,  with 
great  pain  about  the  pelvis,  the  os  coccygis,  and  the  heads  of  the 
thigh-bones,  preventing  the  patient  from  walking  or  (landing 
erect,  with  increafe  of  pain  on  going  to  ftool.  This  malady,  as 
well  as  the  preceding,  has  been  afcribed  to  rheumatifm ;  with 
which  it  feems  to  bear  no  greater  analogy,  than  the  inflamma- 
tions of  any  other  membranes. 

The  patients  are  left  feeble,  and  fometimes  lame  after  this 
difeafe  ;  which  is  alfo  fometimes  accompanied  with  great  flow 
of  urine,  owing  to  the  defective  abforption  of  its  aqueous  parts  ; 
and  with  confequent  thirft  occafioned  by  the  want  of  fo  much 
fluid  being  returned  into  the  circulation  ;  a  lodgment  of  faeces 
in  the  rectum  fometimes  occurs  after  this  complaint  from  the 
leflened  fenfibility  of  it.  See  Clafs  I.  2.  4.  i$. 

M.  M.  Venefection  ;  gentle  cathartics ;  diluents ;  fomenta- 
tion ;  poultice  with  camomile  flowers,  turpentine,  foap,  and 
opium;  afterwards  the  bark.  See  Clafs  I.  i.  3.  5. 

When  this  inflammation  terminates  in  fuppuration  the  matter 
generally  can  be  felt  to  fluctuate  in  the  groin,  or  near  the  top  of 
the  thigh.  In  this  circumftance,  my  friend  Mr.  Bent,  furgeon, 

near 


1 8*  DISEASES  CLASS  II.  i.  2.  19. 

near  Newcaftle  in  Stafford  (hire,  propofes  to  tap  the  abfcefs  by 
means  of  a  trocar,  and  thus  as  often  as  neceffary  to  difcharge  the 
matter  without  admitting  the  air.  Might  a  weak  injection  of 
wine  and  water,  as  in  the  hydrocele,  be  ufed  with  great  caution 
to  inflame  the  walls  of  the  abfcefs,  and  caufe  them  to  unite  ? 
SeeClafsII.  1.6.9. 

T  9.  Paronychia  interna.  Inflammation  beneath  the  finger-nail. 
The  pain  occafioned  by  the  inflammatory  action  and  tumor  of 
parts  bound  down  between  the  nail  on  one  fide  and  the  bone  on 
the  other,  neither  of  which  will  yield,  is  faid  to  occafion  fo  much 
pain  as  to  produce  immediate  delirium,  and  even  death,  except 
the  parts  are  divided  by  a  deep  incifion  ;  which  muft  pafs  quite 
through  the  periofteum,  as  the  inflammation  is  faid  generally  to 
exift  beneath  it.  This  difeafe  is  thus  refembled  by  the  procefs 
of  toothing  in  young  children  ;  where  an  extraneous  body  lodged 
beneath  the  periofteum  induces  pain  and  fever,  and  fometimes 
delirium,  and  requires  to  be  fet  at  liberty  by  the  lancet. 


GRDO 


CLASS  II.  i .  3.  OF  SENSATION,  I  g i 

ORDO  i. 

Increafed  Senfation. 
GENUS  III. 

With  the  Production  of  new  Veffeh  by  external  Membranes  of 
Glands  i  with  Fever. 

THE  difeafes  of  this  genus  are  perhaps  all  produ&ive  of  con- 
tagious matter  •,  or  which  becomes  fo  by  its  expofure  to  the  air, 
either  through  the  cuticle,  or  by  immediate  contact  with  it ; 
fuch  are  the  matters  of  the  fmall-pox  and  meafles.  The  puru- 
lent matter  formed  on  parts  covered  from  the  air  by  thicker 
membranes  or  mufcles,  as  in  the  preceding  genus,  does  not  in- 
duce fever;  and  cannot  therefore  be  called  contagious  ;  but  it 
acquires  this  property  of  producing  fever  in  a  few  hours,  after 
the  abfcefs  has  been  opened,  fo  as  to  admit  the  air  to  its  furface, 
and  may  then  be  faid  to  confift  of  contagious  miafmata.  This 
kind  of  contagious  matter  only  induces  fever,  but  does  not  pro- 
duce other  matter  with  properties  fimilar  to  its  own  ;  and  in 
this  refpecT:  it  differs  from  the  contagious  miafmata  of  fmall-pox 
or  meafles,  but  refembles  thofe  which  have  their  origin  in  crowd- 
ed jails  ;  for  thefe  produce  fever  only,  which  frequently  de- 
flroys  the  patient ;  but  do  not  produce  other  matters  fimilar  to 
themfelves  j  as  appears  from  none  of  thofe  who  died  of  the  jail- 
fever,  caught  at  the  famous  black  aflizes  at  Oxford,  at  the  be- 
ginning of  this  century,  having  infedted  their  phyficians  or  at- 
tendants. 

If  indeed  the  matter  has  continued  fo  long  as  to  become  pu- 
trid, and  thus  to  have  given  out  air  from  a  part  of  it,  it  acquires 
the  power  of  producing  fever  -,  in  the  fame  manner  as  if  the  ul- 
cer had  been  opened,  and  expofed  to  the  common  air  ;  inftan- 
ces  of  which  are  not  unfrequent.  B  And  from  thefe  circumftan- 
ces  it  feems  probable,  that  the  matters  fecreted  by  the  new  veflels 
formed  in  all  kinds  of  phlegmons,  or  puftules,  are  not  conta- 
gious, till  they  have  acquired  fomething  from  the  atmofphere, 
or  from  the  gas  produced  by  putrefaction  ;  which  will  account 
for  fome  phenomena  in  the  lues  venerea,  cancer,  and  of  other 
contagious  fecretions  on  the  fkin  without  fever,  to  be  mention- 
ed hereafter.  See  Clafs  II.  i.  4.  14. 

The  theory  of  contagion  has  been  perplexed  by  comparing  it 
with  fermenting  liquors  •,  but  the  contagious  material  is  (hewn 
in  Seclion  XXXIII.  to  be  produced  like  other  fecreted  matters 

by 


DISEASES  CLASS  II.  1.3. 

By  certain  animal  motions  of  the  terminations  of  the  vefTels, 
Hence  a  new  kind  of  gland  is  formed  at  the  terminations  of  the 
reffels  in  the  eruptions  of  the  fmall-pox  j  the  animal  motions  of 
which  produce  from  the  blood  variolous  matter ;  as  other  glands 
produce  bile  or  faliva.  Now  if  fome  of  this  matter  is  introdu- 
ced beneath  the  cuticle  of  a  healthy  perfon,  or  enters  the  circula- 
tion, and  excites  the  extremities  of  the  blood-veffels  into  thofe 
kinds  of  difeafed  motions,  by  which  it  was  itfelf  produced,  either 
by  irritation  or  affociation,  thefe  difeafed  motions  of  the  extremi- 
ties of  the  veffels  will  produce  other  fimilar  contagious  matter. 
See  Sect.  XXXIII.  2.  5.  and  9.  Hence  contagion  feems  to  be 
propagated  two  ways  ;  one,  by  the  ftimul us  of  contagious  mat- 
ter applied  to  the  part,  which  by  an  unknown  law  of  nature  ex- 
cites the  ftimulated  veffels  to  produce  a  fimilar  matter ;  as  in 
venereal  ulcers,  which  thus  continue  to  fpread  ;  or  as  when  va- 
riolous matter  is  inferted  beneath  the  cuticle  ;  or  when  it  is 
fuppofed  to  be  abforbed,  and  diffufed  over  the  body  mixed  with 
the  blood,  and  applied  in  that  manner  to  the  cutaneous  glands. 
The  other  way,  by  which  contagion  feems  to  be  diffufed,  is  by 
fome  diilant  parts  fympathizing  or  imitating  the  motions  of  the 
part  firft  affected  j  as  the  ftomach  and  fkin  in  the  eruptions  of 
the  inoculated  fmall-pox,  or  in  the  bite  of  a  mad  dog  ;  as  treat- 
ed of  in  Sea.  XXII.  3.  3. 

In  fome  of  the  difeafes  of  this  genus,  the  pulfe  is  Itrong,  full, 
and  hard,  conftituting  the  fenfitive  irritated  fever,  as  defcribed 
in  the  preceding  genus  ;  as  in  one  kind  of  eryfipelas,  which  re- 
quires repeated  venefection.  In  others  the  arterial  action  is 
fometimes  moderate,  fo  as  to  conftitute  the  fenfitive  fever,  as  in 
the  inoculated  fmall-pox ;  where  the  action  of  the  arteries  is 
neither  increafed  by  the  fenforial  power  of  irritation,  as  in  the 
fenfitive  irritated  fever  j  nor  decreased  by  the  defect  of  that  pow- 
er, as  in  the  fenfitive  inirritated  fever.  But  in  the  greateft  num- 
ber of  the  difeafes  of  this  genus  the  arterial  action  is  greatly  di- 
minilhed  in  refpect  to  ftrength,  and  confequently  the  frequen- 
cy of  pulfation  is  proportionally  increafed,  as  explained  in  Sect. 
XXX1L  2,  i.  Which  is  owing  to  the  deficiency  of  the  fenfo- 
rial pov/er  of  irritation  joined  with  the  increafe  of  tnat  of  fenfa- 
tion,  and  thus  constitutes  the  fenfitive  inirritated  fever  •>  as  in, 
fcarlatina  with  gangrenous  tonfils. 

From  this  great  debility  of  the  action  of  the  arteries,  there 
appears  to  be  lefs  of  the  coagulable  lymph  or  mucus  fecreted  on 
their  internal  furfaces  ;  whence  there  is  not  only  a  defect  of 
that  buff  or  fize  upon  the  blood,  which  is  feen  on  the  furface  of 
that  which  is  drawn  in  the  fenfitive  irritated  fever  ;  but  the 
blood,  as  it  cools,  when  it  has  been  drawn  into  a  bafm,  fcarcely 

coagulates  j 


CLASS  II.  t.  3.  OF  SENSATION.  igj 

coagulates  ;  and  is  faid  to  be  diflblved,  and  is  by  fome  fuppofed 
to  be  in  a  (late  of  actual  putrefaction.  See  Sect.  XXXIII.  I. 
3.  where  the  truth  of  this  idea  is  controverted.  But  in  the  fe- 
vers of  both  this  genus  and  the  preceding  one,  great  heat  is  pro- 
duced from  the  chemical  combinations  in  the  iecretions  of  new 
veflels  and  fluids,  and  pain  or  uneafmefs  from  the  diftention  of 
the  old  ones  -y  till  towards  the  termination  of  the  difeafe  fenfa- 
tion  ceafes,  as  well  as  irritation,  with  the  mortification  of  the 
affected  parts,  and  the  death  of  the  patient. 

Dyfenteria,  as  well  as  tonfiliitis  and  aphtha,  are  enumerated 
amongft  the  difeafes  of  external  membranes,  becaufe  they  are 
expofed  either  to  the  atmofpheric  air,  which  is  breathed  and 
fwallowed  with  our  food  and  faliva  ;  or  they  are  expofed  to  the 
inflammable  air,  or  hydrogen,  which  is  generated  in  the  intef- 
tines  ;  both  which  contribute  to  produce  or  promote  the  conta- 
gious quality  of  thefe  fluids  ;  as  mentioned  in  Clafs  II.  i .  6. 

It  is  not  fpeaking  accurate  language,  if  we  fay,  that,  in  the 
difeafes  of  this  genus  the  fever  is  contagious  ;  fmce  it  is  the  ma- 
terial produced  by  the  external  membranes  which  is  contagious, 
after  it  has  been  expofed  to  air  ;  while  the  fever  is  the  confe- 
quence  of  this  contagious  matter,  and  not  the  caufe  of  it.  As 
appears  from  the  inoculated  fm all-pox,  in  which  the  fever  does 
not  commence,  till  after  fuppuration  has  taken  place  in  the  in- 
oculated arm,  and  from  the  difeafes  of  the  fifth  genus  of  this 
order,  where  contagion  exifts  without  fever.  See  Clafs  II.  i. 
5.  and  II.  i.  3.  1 8. 

The  exiftence  of  contagious  miafmata  in  the  atmofphere  was 
believed  even  in  the  time  of  Homer,  and  was  allegorized  under 
the  title  of  the  arrows  of  Apollo.  See  catarrhus  contagiofus, 
II.  i.  3.  6.  Of  thefe  it  is  probable,  that  fome  contagious  mat- 
ters are  only  cliffufed  in  the  atmofphere,  as  that  of  the  fmall- 
pox,  as  it  feems  only  to  infect  thofe  who  are  very  near  the  va- 
riolous  patient  ;  and  feems  to  be  fwallowed  with  the  faliva,  and 
thence  to  affect  the  tonfils.  Other  contagions  may  be  diffolved 
in  the  atmofphere,  as  that  of  the  meafles,  and  of  epidemic  ca- 
tarrhs, which  therefore  firft  affect  the  membranes  of  the  noftrils 
in  men,  and  of  the  maxillary  fmufes  alfo  in  dogs  and  horfes. 

Contagious  materials  have  been  alfo  believed  from  remote 
antiquity  to  lodge  in  the  walls  of  rooms  where  the  fick  have 
been  confined  ;  as  in  the  wards  of  hofpitals,  jails,  {hips,  as  well 
as  in  the  bedding  or  clothes  of  the  infected.  The  methods  of 
purifying  infected  houfes  feem  alfo  to  have  been  ftudied  in  the 
remote  times  ;  the  Levitical  law  directs  the  walls  of  the  houfe 
of  a  leprous  perfon  to  be  fcraped ;  and  in.  modern  times  white- 

waftiings 


184  tolSEASES  CLASS  II.  i.  3. 

waftiirigs  with  li-me  and  painting  with  oil  have  been  dtfedted,  I 
beiieve  with  great  fuccefs. 

Mr.  Cruickfhank  has  lately  recommended  two  or  three  parts 
of  fulphur  with  one  of  nitre  to  be  mixed  together,  and  fet  in  a 
room  clofe  (hut  up,  and  ignited  by  dropping  a  lighted  coal  up- 
on it ;  as  the  nitre  will  fupply  fufficient  oxygen  to  inflame  the 
fulphur  in  a  clofe  apartment,  and  thus  to  fill  the  whole  with  the 
fulphurous  vapour  5  fo  as  to  pafs  into  every  minute  aperture  of 
the  walls  or  furniture. 

Another  means  of  fweetening  the  air  of  hofpitals,  where  ma- 
ny ulcerous  patients  are  crowded  together,  has  been  alfo  recom- 
mended, and  might  perhaps  be  ufed  with  falutary  effecl:  to  re- 
ilore  the  air  of  play-houfes,  churches,  clofe  parlours,  courts  of 
law,  and  other  places,  where  many  people  refort  without  due 
ventilation,  which  confifts  in  well  mixing  four  ounces  of  com- 
mon fait  with  two  ounces  of  pulverized  manganefe  in  a  bafm, 
to  thefe  are  then  to  be  added  about  two  ounces  of  water,  and  af- 
terwards three  ounces  of  concentrated  fulphuric  acid,  in  fmall 
portions  ait  a  time  ;  and  when  managed  in  this  way  the  gas  is 
faid  not  to  be  in  the  lead  offenfive  itfelf,  and  at  the  fame  time 
deflroys  difagreeable  fmells,  and  perhaps  alfo  infectious  miaf- 
mata.  Medical  Review,  No.  32. 

The  white  vapours,  not  the  red  ones,  of  nitrous  acid  have  been 
employed  with  wonderful  fuccefs,  by  Dr.  C.  Smyth,  in  the  hof- 
pital  (hips,  without  removing  the  patients  -,  fome  fand  is  made 
hot  in  crucibles,  many  of  which  are  brought  into  the  rooms  to 
be  fumigated ;  in  this  hot  fand  is  then  fet  a  tea-cup  containing 
about  half  an  ounce  of  concentrated  vitriolic  acid,  to  which,  af- 
ter it  had  acquired  a  proper  heat,  an  equal  quantity  of  nitre  in 
powder  is  gradually  added,  and  the  mixture  flirred  with  a  glafs 
ipatula,  till  the  vapour  arifes  from  it  irt  confiderable  quantity. 
The  crucible  or  pipkin  is  then  carried  about  the  wards  by  the 
nurfes  or  convalefcents,  who  walk  about  with  them,  like  incenfe- 
pots,  in  their  hands,  and  by  thus  fumigating  the  (hip  morning 
and  night,  with  the  care  of  warning  the  beds  and  clothes,  and 
expofmg  them  to  the  air,  the  contagion  appeared  to  be  quickly 
flopped,  and  the  patients  already  affected  foon  recovered. 

If  any  metalic  vefTel  be  ufed,  the  white  nitrous  vapour  be- 
comes red,  and  what  was  falutary  before  becomes  now  noxious, 
as  is  obferved  by  Mr.  Keir,  in  his  letter  on  this  fubjecl,  who 
adds,  that  though  much  vital  air  is  extricated  from  the  mixture, 
he  rather  afcribes  its  good  effect  to  the  known  property  of  ail 
mineral  acids  in  flopping  the  procefles  of  fermentation  and  pu- 
trefaclion  ;  as  the  contagious  miafmata  are  prefurned  to  confift 

of 


CLASS  II.   1.3.1-        OF  SENSATION.  185 

of  animal  matter  in  fome  vicious  kind  of  fermentation.     Medi« 
cui  Review,  Vol.  III.  p.   17. 

SPECIES. 

I.  Febris  fe nfttiva  inirritata.  Sensitive inirritated fever.  Ty- 
phus gravior.  Putrid  malignant  fever.  Jail  fever.  The  imme- 
diate caufe  of  this  difeafe  is  the  increafe  of  the  fenforial  power  o! 
fenfation,  joined  with  the  decreafe  of  the  fenforial  power  of  ir- 
ritation ;  that  is,  it  confifts  in  the  febris  fenfitiva  joined  with  the 
febris  inirritativa  of  Clafs  I.  2.  i.  I.  as  the  febris  fenfitiva  irri- 
tata  of  the  preceding  geniis  confifts  of  the  febris  fenfitiva  joined 
\viththefebrisirritativa  of  Clafs  I.  i.  i.  i.  In  both  which 
the  words  irritata,  and  inirritata,  are  defigned  to  exprefs  more 
Or  lefs  irritation  than  the  natural  quantity ;  and  the  fame  when 
applied  to  fome  of  the  difeafes  of  this  genus. 

This  fever  is  frequently  accompanied  with  topical  inflamma- 
tion, which  is  liable,  if  the  arterial  ftrength  is  not  fupported,  to 
end  in  fphacelus  ;  and  as  mortified  parts,  fuch  as  floughs  of  the 
throat,  if  they  adhere  to  living  parts,  foon  become  putrid  from 
the  warmth  and  moifture  of  their  fituation  ;  thefe  fevers  have 
been  termed  putrid,  and  have  been  thought  to  owe  their  caufe 
to  what  is  only  their  confequence.  In  hot  climates  this  fever  is 
frequently  induced  by  the  exhalations  of  ftagnating  lakes  or 
marfhes,  which  abound  with  animal  fubftances ;  but  which  in 
colder  countries  produce  fevers  with  debility  only,  as  the  quar- 
tan ague,  without  inflammation. 

The  fenfitive  inirritated,  or  malignant,  fever  is  alfo  frequently 
produced  by  the  putrid  exhalations  and  ftagnant  air  in  prifons  ; 
but  perhaps  moft  frequently  by  contact  or  near  approach  of  the 
perfons  who  have  refided  in  them.  Thefe  caufes  of  malignant 
fevers  contributed  to  produce,  and  to  fupport  for  a  while,  the 
feptic  and  antifeptic  theory  of  them;  fee  Seel;.  XXXIII.  i.  3. 
The  vibices  or  bruifes,  and  petechiae  or  purples,  were  believed 
to  be  owing  to  the  diffblved  (late  of  the  blood  by  its  incipient 
putrefaction  ;  but  hydroitatical  experiments  have  been  made, 
which  mew  the  fizy  blood  of  the  patient  in  fenfitive  irritated  or 
inflammatory  fever,  with  ftrong  pulfe,  is  more  fluid,  while  it  is 
warm,  than  this  uneoagulable  blood  taken  in  this  fenfitive  inir- 
ritated, or  malignant  fever  ;  from  whence  it  is  inferred,  that  thefe 
petechiae,  and  vibices,  are  owing  to  the  deficient  power  of  abibrp- 
lion  in  the  terminations  of  the  veins.  See  Clafs  I.  2.  I.  5. 

This  fenfitive  inirritated  fever,  or   typhus  gravior,  is  diftin- 
gniihed  from  the  inirritative  fever,  or  typhus  mitior,  in  the  ear- 
ages  of  it,  by  the  colour  of  the  {kin  ;  which  in  the  latter  is 

VOL.  II.  A  A 


1 86  DISEASES  CLASS  II.  i.  3.  i, 

paler,  with  lefs  heat,  owing  to  the  lefs  violent  action  of  the  ca- 
pillaries ;  in  this  it  is  higher  coloured,  and  hotter,  from  the  great- 
er energy  of  the  capillary  action  in  the  production  of  new  vef- 
fels.  In  the  more  advanced  (late  petechise,  and  the  production 
of  contagious  matter  from  inflamed  membranes,  as  the  aphthae 
of  the  mouth,  or  ulcers  of  the  throat,  diftinguim  this  fever  from 
the  former.  Delirium,  and  dilated  pupils  of  the  eyes,  are  more 
frequent  in  nervous  fevers  *,  and  ftupor  with  deafnefs  a  more 
frequent  attendant  on  malignant  fevers.  See  Clafs  I.  2.  5.  6. 

There  is  another  criterion  difcernible  by  the  touch  of  an  ex- 
perienced finger  ;  and  that  is,  the  coat  of  the  artery  in  inflamma- 
tory fevers,  both  thofe  attended  with  ftrength  of  pulfation,  and 
thefe  with  weak  pulfation,  feels  harder,  or  more  like  a  cord  ; 
for  the  coats  of  the  arteries  in  thefe  fevers  are  themfelves  infla- 
med and  are  confequently  turgid  with  blood,  and  thence  are  lefs 
eafily  comprefled,  though  their  pulfations  are  neverthelefs  weak  : 
when  the  artery  is  large  or  full  with  an  inflamed  coat,  it  is  called 
hard  ;  and  when  fmall  or  empty  with  an  inflamed  coat,  it  is 
called  fharp,  by  many  writers. 

M.  M.  The  indications  of  cure  confift,  i.  In  procuring  a 
regurgitation  of  any  ofFenfive  material,  which  may  be  lodged  in 
the  long  mouths  of  the  lacteals  or  lymphatics,  or  in  their  tumid 
glands.  2.  To  excite  the  fyftem  into  necellary  action  by  the 
repeated  exhibition  of  nwtrientia,  forbcntia,  and  incitantia  ;  and 
to  preferve  the  due  evacuation  of  the  bowels.  3.  To  prevent 
any  imneceffary  expenditure  of  fenforidl  power.  4.  To  prevent 
the  formation  of  ulcers,  or  to  promote  the  abforption  in  them, 
for  the  purpofe  of  healing  them. 

1.  One  ounce  of  wine  of  ipecacuanha,  or  about  ten  grains  of 
the  pow'der,  ihould  be  given  as  an  emetic.     After  a  few  hours- 
three  or  four  grains  of  calomel  iliould  be  given  in  a  little  mu- 
cilage, or  conferve.     Where  fomething  fwallowecfinto  the  ftom- 
ach  is  the  caufe  of  the  fever,  it  is  liable  to  be  arrefted  by  the  lym- 
phatic glands,  as  the  matter  of  the  fmall-pox  inoculated  in  the  arm 
is  liable  to  be  Hopped  by  the  axillary  lymphatic  gland  ;  in  this 
fituation  it  may  continue   a  day  or  two,  or  longer,  and  may  be 
regurgitated  during  the  operation  of  an  emetic  or  cathartic  into 
the  ftomach  or  bowel,  as  evidently  happens  on  the  exhibition  of 
calomel,  as  explained  in  Seel.  XXIX.   7.   2.     For   this  reafon 
an  enietic  and  cathartic,  with   venefection,  if   indicated  by  the 
hardneis  and  fulnefs  of  the  pulfe,   will  very  frequently  remove 
fevers,  if  exhibited  on  the  firft,  fecond,  or  even  third  day. 

2.  Wine  and  opium,  in  fmall  dofes  repeated  frequently,  but 
fo  that  not  the  leal!  degree  of  intoxication  follows,  for  in  that 
cafe  a  greater  degree  of  debility  is   produced  jroni  the  expendi- 
ture 


CLASS  II.  i.  3.  i.        OF  SENSATION.  187 

ture  of  fenforial  power  in  unneceflary  motions.  Many  weak 
patients  have  been  thus  ftimulated  to  death.  See  Se<fh  Xfl.  7. 
S.  The  Peruvian  bark  ihould  be  given  alfo  in  repeated  doles 
in  fuch  quantity  only  as  may  ftrengthen  digeftion,  not  impede 
it.  For  thefe  purpofes  two  ounces  of  wine,  or  of  ale,  or  cyder, 
fhould  be  given  every  fix  hours ;  and  two  ounces  of  decoction 
of  bark,  with  two  drachms  of  the  tincture  of  bark,  and  fix  drops 
of  tincture  of  opium,  fhould  be  given  alfo  every  fix  hours  alter- 
nately ;  that  is,  each  of  them  four  times  in  twenty-four  hours. 
As  much  rhubarb  as  may  induce  a  daily  evacuation,  Ihould  be 
given  to  remove  the  colluvies  of  indigefted  materials  from  the 
bowels  ;  which  might  otherwife  increafe  the  diftrefs  of  the  pa- 
tient by  the  air  it  gives  out  in  putrefaction,  or  by  producing 
a  diarrhoea  by  its  acrimony  ;  the  putridity  of  the  evacuations 
is  owing  to  the  total  inability  of  the  dige (live ^powers  ;  and  their 
delay  in  the  interlines,  to  the  inactivity  of  that  canal  in  refpect 
to  its  perifbltic  motions. 

The  quantities  of  wine  or  beer  and  opium,  and  bark,  above- 
mentioned,  may  be  increafed  by  degrees,  if  the  patient  feems 
refrefhed  by  them ;  and  if  the  pulfe  becomes  flower  on  their 
exhibition  ;  but  this  with  caution,  as  I  have,  feen  irrecover- 
able mifchief  done  by  greater  quantities  both  of  opium,  wine, 
and  bark,  in  this  kind  of  fever  ;  in  which  their  ufe  is  to  ftrength- 
en  the  drgeftion  of  the  weak  patient,  rather  than  to  flop  the  par- 
oxyfms  of  fever  ;  but  when  they  are  adminiftered  in  intermit- 
tents,  much  larger  quantities  are  necefTary. 

The  ftimulus  of  fmall  blifters  applied  in  fucceffion,  one  every 
three  or  four  days,  when  the  patient  becomes  weak,  is  of  great 
fervice  by  flrengthening  digeftion,  and  by  preventing  the  cokl- 
nefs  of  the  extremities,  owing  to  the  fympathy  of  the  fkin  with 
the  flomach,  and  of  one  part  of  the  fkin  with  another. 

In  refpect  to  nutriment,  the  patient  mould  be  fupplied  with 
wine  and  water,  with  toafted  bread,  and  fugar  or  fpice  in  it ;  or 
with  fago  with  wine  ;  frefh  broth  with  turnips,  cellery,  parfley, 
fruit ;  new  milk.  Tea  with  cream  and  fugar ;  bread-pudding, 
with  lemon-juice  and  fugar  ;  chicken,  fifh,  or  whatever  is  grate- 
ful to  the  palate  of  the  fick  perfon,  in  fmall  quantity  repeated  fre- 
quently ;  with  fmall  beer,  cyder  and  water,  or  wine  and  water, 
for  drink,  which  may  be  acidulated  with  acid  of  vitriol  in  fmall 
quantities. 

3.  All  unneceflary  motions  are  to  be  checked,  or  prevented. 
Hence  horizontal  pofture,  obfcure  room,  filence,  cool  air.  All 
the  parts  of  the  fkin,  which  feel  too  hot  to  the  hand,  mould  be 
expofed  to  a  current  of  cool  air,  or  bathed  with  cold  water, 
whether  there  are  eruptions  on  it  or  not.  Warn  the  patient 

twice 


x«8  DISEASES  CLASS  II.  i.  3.2. 

twice, a  day  with  cold  vinegar  and  water,  or  cold  fait  and  water, 
or  cold  water  alone,  by  means  of  a  fponge.  If  fome  parts  are 
too  cold,  as  the  extremities,  while  other  parts  are  too  hot,  as  the 
face  or  breaft,  cover  the  cold  parts  with  flannel,  and  cool  the 
hot  parts  by  a  current  of  cool  air,  ^r  bathing  them  as  above. 

4.  For  the  healing  of  ulcers,  if  in  the  mouth,  folution  of 
alum  in  water  about  40  grains  to  an  ounce,  or  of  blue  vitriol 
in  water,  one  grain  or  two  to  an  ounce  may  be  ufed  to  touch 
them  with  three  or  four  times  a  day.  Of  thefe  perhaps  a  folu- 
tion of  alum  is  to  be  preferred,  as  it  inftantly  takes  away  the 
flench  from  ulcers  I  fuppofe  by  combining  with  the  volatile  al- 
kali which  attends  it.  For  this  purpofe  a  folution  of  alum  of  an 
ounce  to  a  pint  of  water  mould  be  frequently  injected  by  means 
of  a  fyringe  into  the  mouth.  If  there  are  ulcers  on  the  exter- 
nal (kin,  fine  powder  of  bark  feven  parts,  and  ceruffa  in  fine 
powder  one  part,  mould  be  mixed  and  applied  dry  on  the  fore, 
and  kept  on  by  lint,  and  a  bandage. 

As  floughs  in  the  mouth  are  frequently  produced  by  the  pre- 
vious drynefs  of  the  membranes  which  line  it,  this  drynefs  mould 
be  prevented  by  frequently  moiftening  them,  which  may  be  ef- 
fected by  injection  with  a  fyringe,  or  by  a  moift  fponge,  or  laft- 
ly  in  the  following  manner.  Place  a  glafs  of  wine  and  water, 
or  of  milk  and  fugar,  on  a  table  by  the  bedfide,  a  little  above  the 
level  of  the  mouth  of  the  patient;  then,  having  previoufly  moif- 
tened  a  long  piece  of  narrow  lifting,  or  cloth,  or  flannel,  with 
the  fame  liquor,  leave  one  end  of  it  in  the  glafs,  and  introduce 
the  other  into  the  mouth  of  the  patient ;  which  will  thus  be  fup- 
plied  with  a  conftant  oozing  of  the  fluid  through  the  cloth, 
which  acts  as  a  capillary  fyphon. 

The  vifcid  phlegm,  which  adheres  to  the  tongue,  mould  be 
coagulated  by  fome  auflere  acid,  as  by  lemon-juice  evaporated 
to  half  its  quantity,  or  by  crab-juice  ;  and  then  it  may  be  fcra- 
ped  off  by  a  knife,  or  rubbed  off  by  flannel,  or  a  fage-leaf  dipped 
in  vinegar,  or  in  fait  and  water. 

2.  Eryjipelas.  St.  Anthony's  fire  may  be  divided  into  three 
kinds,  which  differ  in  their  method  of  cure,  the  irritated,  the  in- 
irritated,  and  the  fenfitive  eryfipelas. 

Eryfipelas  irritatum  is  attended  with  increafe  of  irritation  be- 
lides  increafe  of  fenfation  ;  that  is,  with  ftrong,  hard  and  full 
pulfe,  which  requires  frequent  venefection,  like  other  inflam- 
mations with  arterial  ftrength.  It  is  diftinguifhed  from  the 
phlegmonic  inflammations  of  the  laft  genus  by  its  fituation  on 
the  external  habit,  and  by  the  rednefs,  heat,  and  tumour,  not  be- 
ing distinctly  circumfcribed  ;  fo  that  the  eye  or  finger  cannot 
exactly  trace  the  extent  of  them. 

Whcg 


GLASS  II.  i.  3.  2.        OF  SENSATION.  189 

When  the  external  ikin  is  the  feat  of  inflammation,  and  pro- 
duces fenfitive  irritated  fever,  no  collection  of  matter  is  formed, 
as  when  a  phlegmon  is  fituated  in  the  cellular  membrane  beneath, 
the  fkin  5  but  the  cuticle  rifes  as  beneath  a  blifter-plafter,  and 
becomes  ruptured  ;  and  a  yellow  material  oozes  out,  and  be- 
comes infpifiated,  and  lies  upon  its  fur  face ;  as  is  feen  in  this 
kind  of  eryfipelas,  and  in  the  confluent  f mall-pox  ;  or  if  the  new 
vefleis  are  reabforbed  the  cuticle  peels  off  in  fcales.  This  differ- 
ence of  the  termination  of  eryfipelatous  and  phlegmonic  inflam- 
mation feems  to  be  owing  in  part  to  the  lefs  diftenfibility  of  the 
cuticle  than  of  the  cellular  membrane,  and  in  part  to  the  ready 
exhalation  of  the  thinner  parts  of  the  fecreted  fluids  through  its 
pores. 

This  eryfipelas  is  generally  preceded  by  a  fever  for  two  or 
three  days  before  the  eruption,  which  is  liable  to  appear  in  fome 
places,  as  it  declines  in  others ;  and  feems  frequently  to  arifc 
from  a  previous  fcratch  or  injury  of  the  fkin ;  and  is  attended 
ibmetimes  with  inflammation  of  the  cellular  membrane  beneath 
the  fkin  ;  whence  a  real  phlegmon  and  collection  of  matter  be- 
come joined  to  the  eryfipelas,  and  either  occafion  or  increafe 
the  irritated  fever,  which  attends  it. 

There  is  a  greater  fympathy  between  the  external  fkin  and 
the  meninges  of  the  brain,  than  between  the  cellular  membrane 
and  thofe  meninges  •,  whence  eryfipelas  is  more  liable  to  be  pre- 
ceded, or  attended,  or  fucceeded,  by  delirium  than  internal 
phlegmons.  I  except  the  mumps,  or  parotitis,  defcribed  below ; 
which  is  properly  an  external  gland,  as  its  excretory  duel:  opens 
into  the  air.  When  pain  of  the  head  or  delirium  precedes  the 
cutaneous  eruption  of  the  face,  there  is  fome  reafon  to  believe, 
that  the  primary  difeafe  is  a  torpor  of  the  meninges  of  the  brain  ; 
and  that  the  fucceeding  violent  aftion  is  transferred  to  the  fkin 
of  the  face  by  fenfitive  affociation  ;  and  that  a  fimilar  fympathy 
occurs  between  fome  internal  membranes  and  the  Ikin  over  them, 
when  eryfipelas  appears  on  other  parts  of  the  body.  If  this  cir- 
cumftance  mould  be  fupported  by  further  evidence,  this  difeafe 
fhould  be  removed  into  Clafs  IV.  along  with  the  rheumatilin 
and  gout.  See  Clafs  IV.  1.2.  17. 

This  fuppofed  retropulfion  of  eryfipelas  on  the  brain  from 
the  frequent  appearance  of  delirium,  has  prevented  the  free  ule 
of  the  lancet  early  in  this  difeafe  to  the  deftruftion  of  m.iny; 
as  it  has  prevented  the  fubduing  of  the  general  nfiamm^ 
and  thus  has  in  the  end  produced  the  particular  one  on  the 
brain.  Mr.  B ,  a  delicate  gentleman  about  fixty,  Ir.id  an  ery- 
fipelas beginning  near  one  ear,  and  extending  by  degrees  over 
the  whole  head,  with  hard,  full,  and  itrongpuilc  ;  blood  was  ta- 
ken 


190  DISEASES  CLASS  II.  i.  3. 2. 

ken  from  him  four  or  five  times  in  confiderable  quantity,  with 
gentle  cathartics,  with  calomel,  diluents,  and  cool  air,  and  he 
recovered  without  any  figns  of  delirium,  or  inflammation  of  the 

meninges  of  the  brain.     Mr.    W ,  a   ftrong  corpulent 

man  of  inferior  life,  had  eryfipelas  over  his  whole  head,  with 
ftrong  hard  pulfe :  he  was  not  evacuated  early  in  the  difeafe 
through  the  timidity  of  his  apothecary,  and  died  delirious.  Mrs. 

f had  eryfipelas  on  the  face,  without  either  ftrong  or  weak 

pulfe ;  that  is,  with  fenfitive  fever  alone,  without  fuperabun- 
dance  or  deficiency  of  irritation  ;  and  recovered  without  any  but 
natural  evacuations.  From  thefe  three  cafes  of  eryfipehs  on  the 
head,  it  appears  that  the  evacuations  by  the  lancet  muft  be  ufed 
with  courage,  where  the  degree  of  inflammation  requires  it ; 
but  not  where  this  degree  of  inflammation  is  fmall,  nor  in  the 
eryirpelas  attended  with  inirritation,  as  defcribed  below. 

M.  M.  Venefeclion  repeated  according  to  the  degree  of  in- 
flammation. An  emetic.  Calomel,  three  grains  every  other 
night.  Cool  air.  Diluents,  emetic  tartar  in  fmall  dofes,  as  a 
quarter  of  a  grain  every  fix  hours.  Tea,  weak  broth,  gruel,  lem- 
onade, neutral  falts.  See  Seel.  XII.  6. 

Such  external  applications  as  carry  away  the  heat  of  the  fldn 
may  be  of  fervice,  as  cold  water,  cold  flour,  fnow,  ether.  Be- 
caufe  thefe  applications  impede  the  exertions  of  the  fecerning 
Teflels,  which  are  now  in  too  great  a£Hon  ;  but  any  applica- 
tions of  the  ftimulant  kind,  as  folutions  of  lead,  iron,  copper, 
or  of  alum,  ufed  early  in  the  difeafe,  muft  be  injurious  •,  as  they 
ftimulate  the  fecerning  veffels,  as  well  as  the  abforbent  veflels, 
into  greater  action ;  exactly  as  occurs  when  ftimulant  eye  wa- 
ters are  ufed  too  foon  in  ophthalmy.  See  Clafs  II.  1.2.  2. 
But  as  the  cuticle  peels  offin  this  cafe  after  the  inflammation  ceaf- 
es,  it  differs  from  ophthalmy ;  and  ftimulant  applications  are 
not  indicated  at  all,  except  where  fymptoms  of  gangrene  appear. 
For  as  a  new  cuticle  is  formed  under  the  old  one,  as  under  a  blif- 
ter,  the  ferous  fluid  between  them  is  a  defence  to  the  new  cuti- 
cle, and  mould  dry  into  a  fcab  by  exhalation  rather  than  be  re- 
abforbed.  Hence  we  fee  how  greafy  or  oily  applications,  and 
even  how  moift  ones,  are  injurious  in  eryfipelas  ;  becaufe  they 
prevent  the  exhalation  of  the  ferous  effufion  between  the  old 
and  new  cuticle,  and  thus  retard  the  formation  of  the  latter. 

Eryfipelas  inirritatum  differs  from  the  former  in  its  being  at- 
tended with  weak  pulfe,  and  other  fymptoms  of  fenfitive  inir- 
ritated  fever.  The  feet  and  legs  are  particularly  liable  to  this 
eryfipelas,  which  precedes  or  attends  the  fphacelus  or  mortifica- 
tion of  thofe  parts.  A  great  and  long  coldnefs  firft  affects  the 
limb,  and  die  eryfipelas  on  the  fldn  feems  to  occur  in  confe- 

quence 


CLASS  II.  i.  3.  2.         OF  SENSATION.  191 

quence  of  the  previous  torpor  of  the  interior  membranes.  As 
this  generally  attends  old  age,  it  becomes  more  dangerous  in 
proportion  to  the  age,  and  alto  to  the  habitual  intemperance  of 
the  patient  in  refpecl:  to  the  ufe  of  fermented  or  fpirituous  liquor. 

When  the  former  kind,  or  irritated  eryfipelas,  continues  long, 
the  patient  becomes  fo  weakened  as  to  be  liable  to  all  the  fymp- 
toms  of  this  inirritated  eryfipelas;  efpecially  where  the  menin- 
ges  of  the  brain  are  primarily  affected.  As  in  that  cafe,  after 
two  or  three  efforts  have  been  made  to  remove  the  returning 
periods  of  torpor  of  the  meninges  to  the  external  {kin,  thofe 
meninges  become  inflamed  themfelves,  and  the  patient  finks  un- 
der the  difeafe  ;  in  a  manner  (imilar  to  that  in  old  gouty  patients, 
where  the  torpor  of  the  liver  or  ftomach  is  relieved  by  afTocJa- 
tion  of  the  inflammation  of  the  membranes  of  the  feet,  and  then 
of  other  joints,  and  laftly  the  power  of  aflbciation  ceafing  to  a6t, 
but  the  excefs  of  fenfation  continuing,  the  liver  or  ftomach  re- 
mains torpid,  or  becomes  itfelf  inflamed,  and  the  patient  is  de- 
ftroyed. 

M.  M.  Where  there  exifts  a  beginning  gangrene  of  the  ex- 
tremities, the  Peruvian  bark,  and  wine,  and  opium,  are  to  be 
given  in  large  quantities  *,  fo  as  to  ftrengthen  the  patient,  but 
not  to  intoxicate,  or  to  impede  his  digeftion  of  aliment,  as  men- 
tioned in  the  firft  fpecies  of  this  genus.  Clafs  II,  i.  2.  I.  But 
where  the  brain  is  inflamed  or  opprefled,  which  is  known  either 
by  delirium,  with  quick  pulfe  ;  or  by  ftupor,  and  flow  refpira- 
tion  with  flow  pulfe  ;  other  means  muft  be  applied.  Such  as, 
firft,  a  fomentation  on  the  head  with  warm  water,  with  or  with- 
out aromatic  herbs,  or  fait  in  it,  mould  be  continued  for  an  hour 
or  two  at  a  time,  and  frequently  repeated.  A  blifter  may  alfo 
be  applied  on  the  head,  and  the  fomentation  neverthelefs  occa- 
fionally  repeated.  Internally  very  gentle  ftimulants,  as  camphor 
one  grain  or  two  in  infufion  of  valerian.  Wine  and  water,  or 
fmall  beer,  weak  broth.  An  enema.  Six  grains  of  rhubarb  and 
one  of  calomel.  Afterwards  five  drops  of  tin£lure  of  opium, 
which  may  be  repeated  every  fix  hours,  if  it  feems  of  fervice. 
Might  the  head  be  bathed  for  a  minute  with  cold  water  ?  or 
•with  ether  ?  or  vinegar  ? 

Eryfipelas  fenfttivitm  is  a  third  fpecies,  differing  only  in  the  kind 
of  fever  which  attends  it,  which  is  fimply  inflammatory,  or  fen- 
fitive,  without  either  excefs  of  irritation,  as  in  the  firft  variety ; 
or  the  defect  of  irritation,  as  in  the  fecond  variety :  all  thefe 
kinds  of  eryfipelas  are  liable  to  return  by  periods  in  fome  people, 
who  have  pafled  the  middle  of  life,  as  at  periods  of  a  lunation, 
or  two  lunations,  or  at  the  equinoxes.  When  thefe  periods  of 
eryfipelas  happen  to  women,  they  feem  to  fupply  the  phce  of 

the 


ip-2  DISEASES  CLASS  II.  i.  3.  3. 

the  receding  catamen;a  ;  when  to  men,  I  have  fometimes  be- 
lieved them  to  be  aflbciated  with  a  torpor  of  the  liver  ;  as  they 
generally  occur  in  thole  who  have  drunk  vinous  fpirit  excefTive- 
ly,  though  not  opprobrioufly ;  and  that  hence  they  fupply  the 
place  of  periodical  piles,  or  gout,  or  gutta  rofea. 

M.  M.  As  the  fever  requires  no  management,  the  difeafe 
takes  its  progrefs  fafely,  like  a  moderate  paroxyfm  of  the  gout ; 
but  in  .this  cafe,  as  in  fome  of  the  former  ;  the  eryfipelas  does 
not  appear  to  be  a  primary  difeafe,  and  ihould  perhaps  be  re- 
moved to  the  Clafsof  Aflbciation. 

3.  Tonfillitis.  Inflammation  of  the  tonfils.  The  uncouth  term 
Cynanche  has  been  ufed  for  difeafes  fo  diffimilar,  that  I  have  di- 
vided them  into  Tonfillitis  and  Parotitis  •,  and  hope  to  be  excufed 
for  adding  a  Greek  termination  to  a  Latin  word,  as  one  of  thofe 
languages  may  juftly  be  confidered  as  a  dialecl:  of  the  other. 
By  tonfillitis  the  inflammation  of  the  tonfils  is  principally  to  be 
wnderftood  ;  but  as  all  inflammations  generally  fpread  further 
than  the  part  fir  ft  affected  ;  fo,  when  the  fummit  of  the  wind- 
pipe is  alfo  much  inflamed,  it  may  be  termed  tonfillitis  trachea- 
lis,  or  croup.  See  Clafs  I.  i.  3.  4.  and  II.  I.  2.  4.  ;  and 
when  the  fummit  of  the  gullet  is  much  inflamed  along  with  the 
tonfil,  it  may  be  called  tonfillitis  pharyngea,  as  defcribed  in  Dr. 
Cullen's  Nofologia,  Genus  X.  p.  92.  The  inflammation  of  the 
tonfils  may  be  divided  into  three  kinds,  which  require  different 
methods  of  cure. 

Tonfillitis  internet.  Inflammation  of  the  internal  tonfil.  When 
the  fwelling  is  fo  confiderable  as  to  produce  difficulty  of  breath- 
ing, the  fize  of  the  tonfil  fhould  be  diminifhed  by  cutting  it  with 
a  proper  lancet,  which  may  either  give  exit  to  the  matter  it  con- 
tains, or  may  make  it  lefs  by  discharging  a  part  of  the  bleed. 
This  kind  of  angina  is  frequently  attended  with  irritated  fever 
befides  the  fenfitive  one,  which  accompanies  all  inflammation, 
and  fometimes  requires  venefeclion.  An  emetic  fhould  be  giv- 
en early  in  the  difeafe,  as  by  its  inducing  the  retrograde  aclion 
of  the  veflels  about  the  fauces  during  the  naufea  it  oecafions,  it 
may  eliminate  the  very  caufe  of  the  inflammation  ;  which  may- 
have  been  taken  up  by  the  abforbents,  and  flill  continue  in  the 
mouths  of  the  lymphatics  or  their  glands.  The  patient  mould 
then  be  induced  to  fwallow  fome  aperient  liquid,  as  an  infuGon 
of  fenna,  fo  as  to  induce  three  or  four  evacuations.  Gargles  of 
all  kinds  are  rather  hurtful,  as  the  action  of  ufing  them  is  lia- 
ble to  give  pain  to  the  inflamed  parts  *,  but  the  patients  find  gre;;! 
relief  from  frequently  holding  warm  water  in  their  mouths,  and 
putting  it  out  again,  or  by  fyringing  warm  water  into  the  mouth, 
as  this  acls  like  a  warm  bath,  or  fomentation  to  the  inflamed 

part. 


CLASS  II.  i.  3,  3-         OF  SENSATION.  193 

part.  Laftly,  fome  mild  ftimulant,  as  a  weak  folution  of  fait 
and  water,  or  of  white  vitriol  and  water,  may  be  uied  to  wafli 
the  fauces  with  in  the  decline  of  the  difeafe,  to  expedite  the  ab- 
forption  of  the  new  veflelsj  if  neceflary,  as  recommended  in 
ophthalmy. 

Tonftllitis  fuperfii-ialis.  Inflammation  of  the  fu^-face  of  the 
tonfils.  As  the  tonfils  and  parts  in  their  vicinity  are  covered 
with  a  membrane,  which  though  expofed  to  currents  of  air,  is 
neverthelefs  conftantly  kept  moift  by  mucus  and  faliva,  and  is 
liable  to  difeafes  of  its  furface  like  other  mucous  membranes,  as 
well  as  to  fuppuration  of  the  internal  fubftance  of  the  gland  ; 
the  inflammation  of  its  furface  is  fucceeded  by  imall  elevated 
puftules  with  matter  in  them,  which  foon  diiappears,  and  the 
parts  either  readily  heal,  or  ulcers  covered  with  Houghs  are  left: 
on  the  furface. 

This  difeaie  is  generally  attended  with  only  fenfitive  fever, 
and  therefore  is  of  no  danger,  and  may  be  dillinguithed  with 
great  certainty  from  the  dangerous  inflammation  or  gangrene 
of  the  tonfils  at  the  height  of  the  fmall-pox,  or  fcarlet  fever,  by 
its  not  being  attended  with  other  fymptoms  of  thofe  difeafes. 
One  emetic  and  a  gentle  cathartic  is  generally  fumcient ;  and  the 
frequent  fwallowing  of  weak  broth,  or  gruel,  both  without  fait 
in  them,  relieves  the  patient,  and  abfolves  the  cure.  When 
thefe  tumours  of  the  tonfils  frequently  return  I  have  fometimes 
fufpetled  them  to  originate  from  the  abforption  of  putrid  matter 
from  decaying  teeth.  See  Glafs  I.  2.  3.  21.  and  II.  2.  2.  I. 

Tonftllitis  inirritata.  Inflammation  of  the  tonfils  with  fenfi- 
tive inirritated  fever  is  a  iymptom  only  of  contagion-;  fever, 
v/hether  attended  with  fcarlet  eruption,  or  with  confluent  fmall- 
pox,  or  otherwilc.  The  matter  of  contagion  is  generally  diff.i- 
fed,  not  dilTolved  in  the  air ;  and  as  this  is  breathed  over  the  mu. 
caginous  furface  of  the  tonfils,  the  contagious  atoms  are  liable 
to  be  arreited  by  the  tonh'l ;  which  therefore  becomes  the  neit 
of  the  future  difeafe,  like  the  inflamed  circle  round  the  inocu- 
lated pundlure  of  the  arm  in  fuppoiltious  fmall-pox.  The  fuell- 
ing is  liable  to  furTocate  the  patient  in  fmali-pox,  and  to  become 
gangrenous  in  fcarlet  fever,  arid  fome  other  contagious  fevers, 
which  have  been  received  in  this  manner.  The  exigence  of  in-* 
{lamination  of  the  tonfil  previous  to  the  fcarlet  eruption,  as  ths 
arm  inflames  in  the  inoculated  fmnll-pox,  and  fuppu-.-acej  before: 
the  variolous  eruption,  fliould  be  a  criterion  of  the  fcarlet  fever 
being  taken  in  this  manner. 

M.  M.     All  the  means  which  ftrengthen  the  patient,   as  in 

the  fenfitive  inirritated  fever,  Ciais  II.    i.   2.    i.     As  it  is  li  ibb 

to  continue  a  whole  lunation  or  more,  great  attention  fliould  b-* 

Voi,.  II.  B  a  Ufed 


194  DISEASES  CLASS  II.  i.  3.  4. 

ufed  to  nourifh  the  patient  with  acidulous  and  vinous  panada, 
broth  with  vegetables  boiled  in  it,  fugar,  cream,  beer  ;  all  which 
given  frequently  will  contribute  much  to  moiften,  clean,  and  heal 
the  ulcufcles,  or  floughs,  of  the  throat ;  warm  water  and  wine, 
or  acid  of  lemon,  mould  be  frequently  applied  to  the  tonfils  by 
means  of  a  fyringe,  or  by  means  of  a  capillary  fyphon,  as  de- 
fcribed  in  Clafs  II.  i.  2.  I.  A  flight  folution  of  blue  vitriolr 
as  two  grains  to  an  ounce,  or  a  folution  of  fugar  of  lead  of  about 
fix  grains  to  an  ounce,  may  be  of  fervice  •,  efpecially  the  latter, 
applied  to  the  edges  of  the  floughs,  drop  by  drop  by  means  of 
a  fmall  glafs  tube,  or  final!  crow-quill  with  the  end  cut  off,  or 
by  a  camePs-hair  pencil  or  fponge  \  to  the  end  of  either  of 
which  a  drop  will  conveniently  hang  by  capillary  attraction  ;  as 
folutions  of  lead  evidently  impede  the  progrefs  of  eryfipelas  on 
the  exterior  {kin,  when  it  is  attended  with  feeble  pulfe.  Yet  a 
folution  of  alum  injected  frequently  by  a  fyringe  is  perhaps  to 
be  preferred,  as  it  immediately  removes  the  fetor  of  the  breath, 
which  rnuft  much  injure  the  patient  by  its  being  perpetually  re- 
ceived into  the  lungs  by  refpiration. 

4.  Parotitis.  Mumps,  or  branks,  is  a  contagious  inflamma- 
tion of  the  parotis  and  maxillary  glands,  and  has  generally  been 
clafled  under  the  word  Cynanche  or  Angina,  to  which  it  bears 
no  analogy.  It  divides  itfelf  into  two  kinds,  which  differ  in  the 
degree  of  fever  which  attends  them,  and  in  the  method  of  cure. 

Parotitis  fuppurans.  The  fuppurating  mumps  is  to  be  diftin- 
guifhed  by  the  acutenefs  of  the  pain,  and  the  fenfitive,  irritated, 
or  inflammatory  fever,  which  attends  it. 

M.  M.  Venefectiori.  Cathartic  with  calomel  three  or  four 
grains  repeatedly.  Cool  air,  diluents.  This  antiphlogiftic  treat- 
ment is  to  be  continued  no  longer  than  is  necefFary  to  relieve 
the  violence  of  the  pain,  as  the  difeafe  is  attended  with  conta- 
gion, and  mull  run  through  a  certain  time,  like  other  fevers 
with  contagion. 

Parotitis  mutalilis.  Mutable  parotitis.  A  fenfitive  fever  on- 
ly, or  a  fenfitive  irritated  fever,  generally  attends  this  kind.  And 
when  the  tumour  of  the  parotis  and  maxillary  glands  fubfides, 
n  new  fwelling  occurs  in  fome  diftant  part  of  the  fyftem  ;  as 
happens  to  the  hands  and  feet,  at  the  commencement  of  the  fec- 
ondary  fever  of  the  fmall-pox,  when  the  tumor  of  the  face  fub- 
fides. This  new  fwelling  in  the  parotitis  mutabilis  is  liable  to 
afreet  the  tefles  in  men,  and  form  a  painful  tumor,  which  fhould 
be  prevented  from  fuppuration  by  very  cautious  means,  if  the 
violence  of  the  pain  threaten  fuch  a  termination  ;  as  by  bathing 
the  part  with  coldilh  water  for  a  time,  venelection,  a  cathartic  j 
or  by  a  bliller  on  the  perinDeum,,  or  fcrotum,  or  a  poultice. 


CLASS  II.  i.  3.' 4-  OF  SENSATION-  W 

.When  women  are  affected  with  this  complaint,  after  the 
f welling  of  the  parotis  and  maxillary  glands  fubfides,  tumor  with 
pain  is  liable  to  affect  their  breads  ;  which,  however,  I  have  nev- 
er feen  terminate  in  fuppuration. 

On  the  retroceflion  of  the  tumor  of  the  teftes  above  defcribecl, 
and  I  fuppofe  of  that  of  the  breads  in  women,  a  delirium  of  the 
calm  kind  is  very  liable  to  occur  ;  which  in  Come  cafes  has  been 
the  firft  fymptom  which  has  alarmed  the  friends  of  the  patient-; 
and  it  has  thence  been  difficult  to  difcover  the  caufe  of  it  with- 
out much  inquiry  ;  the  previous  fymptoms  having  been  fo  flight 
as  not  to  have  occafioned  any  complaints.  In  this  delirium,  if 
the  pulfe  will  bear  it,  venefeclion  mould  be  ufed,  and  three  or 
four  grains  of  calomel,  with  fomentation  of  the  head  with  warm 
water  for  an  hour  together  every  three  or  four  hours. 

Though  this  difeale  generally  terminates  favourably  confide.r- 
ing  the  numbers  attacked  by  it,  when  it  is  epidemic,  yet  it  is 
dangerous  at  other  times  in  every  part  of  its  progrefs.  Some, 
times  the  parotis  or  maxillary  glands  fuppurate,  producing  ul- 
cers which  are  difficult  to  cure,  and  frequently  deflroy  the  pa- 
tient, where  there  was  a  previous  fcrophulous  tendency.  The 
teftis  in  men  is  alfo  liable  to  fuppurate  with  great  pain,  long  con- 
finement, and  much  danger ;  and  ladly,  the  affection  of  the 
brain  is  fatal  to  many. 

Mr.  W.  W.  had  a  fwelled  throat,  which  after  a  few  days 
fubfided.  He  became  delirious  or  ftupid,  in  which  date  he  was 
dying  wAen  I  faw  him  ;  and  his  friends  afcribed  his  death  to  a 
coup  de  foleil,  which  he  was  faid  to  have  received  fome  months 
before,  when  he  was  abroad. 

Mr.  A.  B.  had  a  fwelling  of  the  throat,  which  after  a  few 
days  fubfided.  When  I  faw  him  he  had  great  dupor,  with  flow 
breathing,  and  partial  delirium.  On  fomenting  his  head  with 
warm  water  for  an 'hour  thefe  fymptoms  of  dupor  were  greatly 
leflened,  and  his  opprefied  breathing  gradually  ceafed,  and  he  re- 
covered in  one  day. 

Mr.  C.  D.  I  found  walking  about  the  houfe  in  a  calm  delir- 
ium without  ftupor  ;  and  not  without  much  inquiry  of  his  friends 
could  get  the  previous  hidory  of  the  difeafe  ;  which  had  been 
attended  with  parotitis,  and  fwelled  tedis,  previous  to  the  deliri- 
um. A  few  ounces  of  blood  were  taken  away,  a  gentle  cathar- 
tic was  directed,  and  his  head  fomented  with  warm  water  for 
an  hour,  with  a  fmall  blider  on  the  back,  and  he  recovered  in 
two  or  three  days. 

Mr.  D.  D.  came  down  from  London  in  the  coach  alone,  fo 
that  no  previous  hidory  could  be  obtained.  He  was  walking  a- 
bout  the  houfe  in  a  calm  delirium,  but  could  give  no  fenfible 

anfwerf 


r     DISEASES  CLASS  II.  j.  3. 5.' 

anfwers  to  anything  which  was  propofed  to  him..  His  pulfe 
was  weak  and  quick.  Cordials,  a  blifter,  the  bark,  were  in  vain 
exhibited,  and  he  died  in  two  or  three  days. 

Mr.  F.  F.  came  from  London  in  the  fame  manner  in  the 
coach.  He  was  mildly  delirious  with  confiderable  ftupor,  and 
moderate  pulfe,  and  could  give  no  account  of  hirnfelf.  He  con- 
tinued in  a  kind'  of  cataleptic  ftupor,  fo  that  he  would  remain 
for  hours  in  any  pofture  he  was  placed,  either  in  his  chair,  or 
in  bed  ;  and  did  not  attempt  to  fpeak  for  about  a  fortnight,  and 
then  gradually  recovered.  Thefe  two  laft  cafes  are  not  related 
as  being  certainly  owing  to  parotitis,  but  as  they  might  probably 
liave  that  origin'. 

The  parotitis  fuppurans,  or  mumps  with  irritated  fever,  is  at 
times  epidemic  among  cats,  and  may  be  called  parotitis  fe Una  ;  as 
I  have  reafon  to  believe  from  the  fwellings  under  the  jaws, 
which  frequently  fuppurate,  and  are  very  fatal  to  thofe  animals; 
In  the  village  of  Hay  wood,  in  S  taffordflnre,  I  remember  a 
whole  breed  of  Perfian  cats,  with  long  white  hair,  was  deftroy- 
ed  by  this  malady,  along  with  almoft  all  the  common  cats  of  the 
neighbourhood  ;  and  as  the  parotitis  or  mumps  had  not  long  b^- 
fbre  prevailed  amongft  human  beings  in  that  part  of  the  coun- 
try, I  recollect  being  inclined  to  believe,  that  the  cats  received 
the  infection  from  mankind  ;  though  in  all  other  contagious  dif- 
eafes,  except  the  rabies  canina  can  be  fo  called,  no  different  gen-- 
era of  animals  naturally  communicate  infection  to  each  other ; 
and  I  am  informed,  that  vain  efforts  have  been  made  to  commu- 
nicate the  fmall-pox  and  meafles  to  fome  quadrupeds  by  inocu- 
lation. A  difeafe  of  the  head  and  neck  deftroyed  almoft  all  the 
cats  in  Weftphalia.  Savage,  Nofol.  Clafs  X.  Art.  30.  8. 

Since  the  above  was  firft  published,  the  cow-pox,  variolse  vac- 
cinse,  has  been  fuccefsfully  inoculated  on  the  human  fubject, 
and  produced  a  difeafe  in  fome  refpects  fimilar  to  the  fmall-pox; 
See  Variolse. 

5.  Catarrhus  fenjitivtis  confifts  of  an  inflammation  of  the 
membrane,  which  lines  the  noftrils  and  fauces.  It  is  attended 
•with  fenfitive  fever  alone,  and  is  cured  by  the  fteani  of  warm 
water  externally,  and  by  diluents  internally,  with  moderate  ven- 
e  fection  and  gentle  cathartics.  This  may  be  termed  catarrhus 
fenfitivus,  to  diftinguifh  it  from  the  catarrhus  contagiofus,  and 
is  in  common  language  called  a  violent  cold  in  the  head  ;  it  dif- 
fers from  the  catarrhus  calidus,  or  warm  catarrh,  cf  Clafs  I.  I. 
2.  7.  in  the  production  of  new  veflels,  or  inflammation  of  the 
membrane,  and  the  confequent  more  purulent  appearance  of 
the  difcharge. 

Raucedo  catarrhalis,or  catarrhal  hoarfenefs,  is  a  frequent  fymp* 

tern, 


CLASS  II.  i.  3.  C.        OF  SENSATION.  %  197 

torn  of  this  difeafe,  and  is  occafioned  by  the  pain  or  forenefs 
M'hich  attends  the  tliickened  and  inflamed  membranes  of  the 
larynx  ;  which  prevents  the  mufcles  of  vocality  from  fufficienr- 
ly  contracting  the  aperture  of  it.  It  ceafes  with  the  inflamma- 
tion, or  may  be  relieved  by  the  fteam  of  warm  water  alone,  or 
of  water  and  vinegar,  or  of  water  and  ether.  See  Paralytic 
Hoarfenefs,  Clafs  III.  2.  1.4. 

6.  Catarrkus  contagicfus.  This  malady  attacks  fo  many  at  the 
fame  time,  and  fpreads  gradually  over  fo  great  an  extent  of  coun- 
try, that  there  can  be  no  doubt  but  that  it  is  difieminated  by  the 
atmofphere.  In  the  year  1 782  the  fun  was  for  many  weeks  ob- 
fcured  by  a  dry  fog,  and  appeared  red  as  through  a  common  mitt. 
The  material,  which  thus  rendered  the  air  muddy,  probably  cauf- 
ed  the  epidemic  catarrh,  which  prevailed  in  that  year,  and  which 
began  far  in  the  north,  and  extended  itfelf  over  all  Europe.  See 
Botanic  Garden,  Vol.  II.  note  on  Chunda,  and  Vol.  I.  Canto  IV. 
line  294,  note  ;  and  was  fuppofed  to  have  been  throws  out  of.a 
volcano,  which  much  difplaced  the  country  of  Iceland. 

In  many  inftances  there  was  reafon  to  believe  that  this  difeafe 
became  contagious,  as  well  as  epidemic  ;  that  is,  that  one  perfon 
might  receive  it  from  another,  as  well  as  by  the  general  unfalu- 
tary  influence  of  the  atmofphere.  This  is  difficult  to  compre- 
hend, but  may  be  conceived  by  confidering  the  increafe  of  conta- 
gious matter  in  the  fmall-pox.  In  that  difeafe  one  particular  of 
contagious  matter  flimulates  the  fkin  of  the  arm  in  inoculation 
into  morbid  action  fo  as  to  produce  a  thoufand  particles  fimilar 
to  itfelf;  the  fame  thing  occurs  in  catarrh,  a  few  deleterious 
atoms  ftimulate  the  mucous  membrane  of  thenoftrils  into  mor- 
bid actions,  which  produce  a  thoufand  other  particles  fimilar  to 
themfelves.  Thefe  contagious  particles  difFufed  in  the  air  muft 
have  confided  of  animal  matter,  otherwife  how  could  an  animal 
body  by  being  ftimulated  by  t].~m  produce  fimilar  particles  ? 
Could  they  then  have  had  a  volcanic  origin,  or  muft  they  not  rath- 
er have  been  blown  from  putrid  marfhes  full  of  animal  matter  ? 
But  the  greateft  part  of  the  folid  earth  has  been  made  from  ani- 
mal and  vegetable  recrements,  which  may  be  difperfed  by  volca- 
noes.— Future  difcoveries  muftanfwer  thefe  queftions. 

As  the  fenfitive  fever  attending  thefe  epidemic  catarrhs  is  fel- 
dom  either  much  irritated  or  inirritated,  venefection  is  not  al- 
ways either  clearly  indicated  or  forbidden ;  but  as  thofe  who 
have  died  of  thefe  catarrhs  have  generally  had  inflamed  livers, 
with  con fequent  fuppuration  in  them,  venefection  is  adviiable, 
wherever  the  cough  and  fever  are  greater  than  common,  fo  as  to 
render  the  ufe  of  the  lancet  in  the  lead  dubious.  And  in  fome 
cafes  a  fecond  bleeding  was  necefiary,  and  a  miid  cathartic  or  two 

with 
•  •* 
V 


DISEASES  CLASS  II.  i.  3.  6. 

with  four  grains  of  calomel ;  with  mucilaginous  fubacid  dilu- 
ents •,  and  warm  {team  occasionally  to  alleviate  the  cough,  fin- 
iihed  the  cure. 

The  catarrhus  contagiofus  is  a  frequent  difeafe  amongfl  horf- 
cs  and  dogs ;  it  feems  firft  to  be  difleminated  amongft  thefe  ani- 
mals by  miafmata  difFufed  in  the  atmofphere,  becaufe  fo  many  of 
them  receive  it  at  the  fame  time  j  and  afterwards  to  be  communi- 
cable from  cue  horfe  or  dog  to  another  by  contagion,  as  above 
defcribcd.  Thefe  epidemic  or  contagious  catarrhs  more  fre- 
quently occur  amongit  dogs  and  horfes  than  amongil  men  \ 
which  is  probably  owing  to  the  greater  extenfion  and  fenfibility 
of  the  mucous  membrane,  which  covers  the  organ  of  fmell,  and 
is  difFufed  over  their  v/ide  noftrils,  and  their  large  maxillary  and 
frontal  cavities.  And  to  this  circumftance  may  be  afcribed  the 
greater  fatality  of  it  to  thefe  animals. 

In  refpect  to  horfes,  I  fufpeft  the  fever  at  the  beginning  to  be 
of  the  fenfitive,  irritated,  or  inflammatory  kind,  becaufe  there  is 
fo  great  a  difcharge  of  purulent  mucus  ;  and  that  therefore  they 
will  bear  once  bleeding  early  in  the  difeafe  ;  and  alfo  one  mild 
purgative,  confiding  of  about  half  an  ounce  of  aloe,  and  as  much 
white  hard  foap,  mixed  together.  They  fhould  be  turned  out 
to  grafs  both  day  and  night  for  the  benefit  of  pure  air,  unlefs  the 
weather  be  too  cold  (and  in  that  cafe  they  fhould  be  kept  in  an 
open  airy  ftable,  without  being  tied),  that  they  may  hang  down 
their  heads  to  facilitate  the  difcharge  of  the  mucus  from  their 
noftrils.  Grafs  (hould  be  offered  them,  or  other  frem  vegeta- 
bles, as  carrots  and  potatoes,  with  mafhes  of  malt,  or  of  oats,  and 
with  plenty  of  frelh  warm  or  cold  water  frequently  in  a  day. 
When  fymptonos  of  debility  appear,  which  may  be  known  by 
the  coldnefs  of  the  ears  or  other  extremities,  or  when  iloughs  can 
be  feen  on  the  membrane,  which  lines  the  nottrils,  a  drink 
con fi (ting  of  a  pint  of  ale  with  half  an  ounce  of  tincture  of  opi- 
um in  it,  given  every  fix  hours,  is  likely  to  be  of  great  utility. 

In  dogs  I  believe  the  catarrh  is  generally  joined  with  fymp- 
toms  of  debility  early  in  the  difeafe.  Thefe  animals  fhould  be 
permitted  to  go  about  in  the  open  air,  and  {hould  have  conftant 
accefs  to  frefh  water.  The  ufe  of  being  as  much  as  may  be  in 
the  air  is  evident,  becaufe  all  the  air,  which  they  breathe,  pafT- 
es  twice  over  the  putrid  floughs  of  the  mortified  parts  of  the 
membrane,  which  lines  the  noftrils,  and  the  maxillary  and  fron- 
tal cavities ;  th.it  is,  both  during  infpiration  and  expiration ; 
and  muft  therefore  be  loaded  with  contagious  particles.  Frem 
new  milk,  and  frefh  broth,  fhould  be  given  them  very  frequently, 
and  they  {hould  be  fuffered  to  go  amongft  the  grafs,  which  they 
fometimes  eat  for  the  purpofe  of  an  emetic  ;  raid  if  poffible  fhould 

have 

: 


CLASS  II.  i.  3. 7.          OF  SENSATION.  199 

have  accefs  to  a  running  flream  of  water.  As  the  contagious 
mucus  of  the  noftrils,  both  of  thefe  animals  and  of  horfes,  gener- 
ally drops  into  the  water,  they  attempt  to  drink.  Bits  of  raw 
flefh,  if  the  dog  will  eat  them,  are  preferred  to  cooked  meat ;  and 
from  five  to  ten  drops  of  tincture  of  opium  may  be  given  with 
advantage,  when  fymptoms  of  debility  are  evident,  according  ta 
the  fize  of  the  dog  every  fix  hours.  If  Houghs  can  be  feen  in 
the  noftrils,  they  fhould  be  moiilened  twice  a  day,  both  in  horf- 
es and  dogs,  with  a  folution  of  fugar  of  lead,  or  of  alum,  by 
means  of  a  fponge  fixed  on  a  bit  of  whale-bone,  or  by  a  fyringc. 
The  lotion  may  be  made  by  diffolving  half  an  ounce  of  fugar  of 
lead,  or  of  alum,  in  a  pint  of  water. 

Ancient  philofophers  feem  to  have  believed,  that  the  conta- 
gious miafmata  in  their  warm  climates  affected  horfes  and  dogs 
previous  to  mankind.  If  thofe  contagious  particles  were  fup- 
pofed  to  be  diffufed  amongft  the  heavy  inflammable  air,  or  car- 
bonated hydrogen,  of  putrid  marmes,  as  thefe  animals  hold  their 
heads  down  lower  to  the  ground,  they  may  be  fuppofed  to  have 
received  them  fooner  than  men.  And  though  men  and  quadru- 
peds might  receive  a  difeafe  from  the  fame  fource  of  marlh-pu- 
trefa&ion,  they  might  not  afterwards  be  able  to  infecl:  each  other, 
though  they  might  infecl:  other  animals  of  the  fame  genus  -,  as 
the  new  contagious  matter  generated  in  their  own  bodies  might 
not  be  precifely  fimilar  to  that  received  ;  as  happened  in  the  jail- 
fever  at  Oxford,  where  thofe  who  took  the  contagion  and  died, 
did  not  infecl  others. 

On  mules  and  dogs  the  infection  firft  began, 
And,  laft,  the  vengeful  arrows  fix'd  on  man. 

Pore's  Homer's  Iliad,  I. 

7.  Peripneumcnia  fuperfidalis .  The  fuperficial  or  fpurious 
peripneumony  confifts  in  an  inflammation  of  the  membrane, 
which  lines  the  bronchia,  and  bears  the  fame  analogy  to  the  true 
peripneumony,  as  the  inflammation  of  other  membranes  do  to 
that  of  the  parenchyma,  or  fubftantial  parts  of  the  vifcus,  which 
they  furround.  It  affecls  elderly  people,  and  frequently  occa- 
fions  their  death  ;  and  exifts  at  the  end  of  the  true  peripneumo- 
ny, or  along  with  it;  when  the  lancet  has  not  becji  uied  fulfi- 
•  ciently  to  cure  by  reabforbing  the  inflamed  parts,  or  what  is  term, 
ed  by  refolution. 

M.  M.  Diluents,  mucilage,  antimonials,  warmifh  air  conftant- 
ly  changed,  venefeclion  once,  perhaps  twice,  if  the  pulfe  will 
bear  it.  Oily  volatile  draughts.  Balfams  ?  Neutral  falts  in- 
creafe  the  tendency  to  cough.  Blifters  in  fucceflion  about  the 
cheil.  Warm  b*ith.  Mild  purgatives.  Very  weak  chicken 

brotfi 


200  DISEASES  GLASS  II.  i.  3. 8. 

broth  without  fait  in  it.  Boiled  onions.  One  grain"  of  cal- 
omel every  night  for  a  week.  From  five  drops  to  ten  of  tintture 
of  opium  at  fix  every  night,  when  the  patient  becomes  weeL 
Digitalis  ?  See  ClafsII.  I.  6.  7. 

8.  PertuJJls.  Tuilis  convulfiva.  Chin-cough  refembles  pe- 
ripneumonia  fuperficialis  in  its  confifting  in  an  inflammation  of 
the  membrane  which  lines  the  air-veifels  of  the  lungs  ;  but  dif- 
fers in  the  circumftance  of  its  being  contagious  j  and  is  on  that 
account  of  very  long  duration  ;  as  the  whole  of  the  lungs  arc 
probably  riot  infecled  at  the  fame  time,  but  the  contagious  in- 
flammation continues  gradually  to  creep  on  the  membrane.  It 
may  in  this  refpedl:  be  compared  to  the  ulcers  in  the  pulmonary 
confumption  ;  but  it  differs  in  this,  that  in  chin-cough  fome 
branches  of  the  bronchia  heal,  as  others  become  inflamed. 

This  complaint  is  not  ufually  clafled  amongft  febrile  diforders, 
but  a  fenfitive  fever  may  generally  be  perceived  to  attend  it  du- 
ring fome  part  of  the  day,  efpecially  in  weak  patients.     And  a 
peripneumony  very   frequently  fupervenes,   and  deftroys  great 
numbers  of  children,  except  the  lancet  or  four  or  fix  leeches  be 
immediately  and  repeatedly  ufed.     When  the  child  has  perma- 
nent difficulty  of  breathing,  which  continues  between  the  cough- 
ing fits  ;  unlefs  blood  be  taken  from  it,  it  dies  in  two,  three,  or 
four  days  of  the  inflammation  of  the  lungs.     During  this  perma- 
nent difficulty   of  breathing,  the    hooping   cough    abates,  or 
quite  ceafes,  and   returns  again  after  once  or  twice  bleeding  \ 
which  is  then  a  good  fymptom,  as  the  child   now  poiTeffing  the 
power  to  cough  (hews  the  difficulty    of  breathing  to  be  abated. 
I  dwell  longer  upon  this,  becaufe  many  lofe  their  lives  from  the 
difficulty  there  is  in  bleeding  young  children  ;  where  the  apoth- 
ecary is  old  or  clumfy,  or  is  not  furnilhed  with  a  very  fharp  and 
fine  pointed  lancet.    In  this  diftreffing  fituation  the  application 
of  four  leeches  to  one  of  the  child's  legs,  the  wounds  made  by 
which  mould  continue  to  bleed  an  hour  or  two,  is  a  fuccedane^ 
um  j  and  faves  the  patient,  if  repeated  once  or  twice,  according 
to  the  difficulty  of  the  refpiration. 

The  chin-cough  feems  to  refemble  the  gonorrhoea  venerea  in 
feveral  circumftances.  They  are  both  received  by  infection,  are 
both  difeafes  of  the  mucous  membrane,  are  both  generally  cured 
in  four  or  fix  weeks  without  medicine.  If  ulcers  in  the  cellular 
membrane  under  the  mucous  membrane  occur,  they  are  of  a 
phagedenic  kind,  and  deftroy  the  patient  in  both  difeafes,  if  no 
medicine  be  adminiftered. 

Hence  the  cure  mould  be  fimilar  in  both  thefe  difeafes  •,  firft 
general  evacuations  and  diluents,  then,  after  a  week  or  two,  I 
have  believed  the  following  pills  of  great  advantage,  The  dofe 

for 


CLASS  II.  i.  3. 9=          OF  SENSATION.  201 

for  a  child  of  about  three  years  old  was  one-fixth  part  of  a  grain 
of  calomel,  one-fixth  part  of  a  grain  of  opium,  and  two  grains 
of  rhubarb,  to  be  taken  twice  a  day. 

The  opium  promotes  abforption  from  the  mucous  membrane, 
and  hence  contributes  to  heal  it.  The  mercury  prevents  ul- 
cers from  being  formed  under  the  mucous  membrane,  or  cures 
them,  as  in  the  lues  venerea  ;  and  the  rhubarb  is  neceflary  to  keep 
the  bowels  open. 

M.  M.  Aniimonial  vomits  frequently  re'peated.  Mild  ca- 
thartics. Cool  air.  Tincture  of  cantharides,  or  repeated  blif- 
ters  ;  afterwards  opiates  in  fmall  dofes,  and  the  bark.  Warm 
bath  frequently  ufed.  The  fleam  of  warm  water  with  a  little 
vinegar  in  it  may  be  inhaled  twice  a  day.  Thirty  drops  of  fatu- 
rated  tincture  of  digitalis  puerpurea,  purple  foxglove,  were  giv- 
en twice  a  day  to  a  lady,  feventy  years  of  age,  in  this  difeafe, 
with  great  and  almofl  immediate -advantage.  I  have  fmce  giv- 
en from  five  to  ten  drops  twice  a  day  to  two  children,  with  alib 
great  apparent  advantage.  See  Art.  IV.  2.  3.  7.  Arfenic 
has  lately  been  recommended  in  the  hooping  cough*  See  Art. 
IV.  2.  6.  9.  And  externally  a  folution  of  20  grains  of  emetic 
tartar,  antimonium  tartarifatum,  in  two  ounces  of  water,  to 
•which  is  to  be  added  one  ounce  of  tincture  of  cantharides,  is  rec- 
ommended, by  Dr.  Struve  of  America,  to  be  rubbed  very  fre- 
quently on  the  region  of  the  ftomach.  Could  the  breathing  of 
carbonic  acid  gas  mixed  with  atmofpheric  air  be  of  fervice  ? 
Copious  venefetlion,  when  a  difficulty  of  breathing  continues  be- 
tween the  fits  of  coughing  ;  otherwife  the  cough  and  the  expec- 
toration ceafe,  and  the  patient  is  deltroyed.  Ulcers  of  the  lungs 
fometimes  fupervene,  and  the  phthifis  nulmonalis  in  a  few 
weeks  terminates  in  death.  Where  the  cough  continues  after 
fome  weeks  without  much  of  the  hooping,  and  a  fenfitive  fever 
daily  fupervenes,  fo  as  to  referable  hectic  fever  from  ulcers  of 
the  lungs  ;  change  of  air  for  a  week  or  fortnight  a£ls  as  a  charm, 
and  reftores  the  patient  beyond  the  hopes  of  the  phyfician. 

Young  children  fhouldlie  with  their  heads  and  fhoulders  raif- 
ed  j  and  mould  be  conftantly  watched  day  and  night  j  that  when 
the  cough  occurs,  they  may  be  held  up  eafily,  fo  as  to  ftand  upon 
theirfeet  bending  a  little  forwards ;  or  nicely  Supported  in  that  pof- 
ture  which  they  feem  to  put  themfelves  into.  Abo w of  whalebone, 
about  the  fize  of  the  bow  of  a  key,  is  very  ufcful  to  extract  the 
phlegm  out  of  the  mouths  of  infants  at  the  time  of  their  coughing ; 
as  a  handkerchief,  if  applied  at  the  time  of  their  quick  inspirations 
after  long  holding  their  breath  is  dangerous,  and  may  fuffbcate 
he  patient  in  an  inftant,  as  I  believe  has  fome  times  happened. 

9.  Variola  difcrtta.  The  imall-pox  is  well  divided  by  Syden- 
II.  C  c  ham 


102  DISEASES  CLASS  II.  i.  3.  9. 

ham  into  diftinct  and  confluent.  The  former  confifls  of  diftin£t 
puftules,  which  appear  on  the  fourth  day  of  the  fever,  are  cir- 
cumfcribed  and  turgid  j  the  fever  ceafmg  when  the  eruption  is 
complete.  Head-ach,  pain  in  the  loins,  vomiting  frequently, 
and  convulfive  fits  fometimes,  precede  the  eruption. 

The  diftinct  fmall-pox  is  attended  with  fenfitive  fever  only, 
when  very  mild,  as  in  mod  inoculated  patients ;  or  with  fenfi- 
tive irritated  fever,  when  the  difeafe  is  greater  :  the  danger  in 
this  kind  of  fmall-pox  is  owing  either  to  the  tumor  and  forenefs 
of  the  throat  about  the  height,  or  eighth  day  of  the  eruption  ; 
or  to  the  violence  of  the  fecondary  fever.  For,  firft,  as  the  nat- 
ural difeafe  is  generally  taken  by  particles  of  the  duft  of  the  con- 
tagious matter  dried  and  floating  in  the  air,  thefe  are  liable  to  be 
arrelled  by  the  mucus  about  the  throat  and  tonfils  in  their  paffage 
to  the  lungs,  or  to  the  ftomach,  when  they  are  previoufly  mixed 
with  faliva  in  the  mouth.  Hence  the  throat  inflames  like  the 
arm  in  inoculated  patients ;  and  this  increasing,  as  the  difeafe 
advances,  deftroys  the  patient  about  the  height. 

Secondly,  all  thofe  upori  the  face  and  head  come  out  about 
the  fame  time,  namely,  about  one  day  before  thofe  on  the  hands, 
and  two  before  thofe  in  the  trunk ;  and  thence,  when  the  head 
is  very  full,  a  danger  arifes  from  the  fecondary  fever,  which  is  a 
purulent  not  a  variolous  fever  ;  for  as  the  matter  from  all  thefe 
of  the  face  and  head  is  reabforbed  at  the  fame  time,  the  patient 
is  deftroyed  by  the  violence  of  this  purulent  fever  ;  which  in  the 
diftinct  fmall-pox  can  only  be  abated  by  venefeclion  and  cathar- 
tics j  but  in  the  confluent  fmall-pox  requires  cordials  and  opi- 
ates, as  it  is  attended  with  arterial  debility.  See  Sect.  XXXV. 
i.  and  XXXIII.  2.  10. 

When  the  puftules  on  the  face  recede,  the  face  fwells ;  and 
when  thofe  of  the  hands  recede,  the  hands  fwell ;  and  the  fame 
of  the  feet  in  fucceffion.  Thefe  fwellings  feem  to  be  owing  ta 
the  abforption  of  variolous  matter,  which  by  its  ftimulus  excites 
the  cutaneous  veflels  to  fecrete  more  lymph,  or  ferum,  or  mucus, 
exactly  as  happens  by  the  ftimulus  of  a  blifter.  Now,  as  a  blif- 
tev  fometimes  produces  ftrangury  many  hours  after  it  has  rifen, 
it  is  plain,  that  a  part  of  the  caritharides  is  abforbed,  and  carri- 
ed to  the  neck  of  the  bladder  ;  whether  it  enters  the  circulation, 
or  is  carried  thither  by  retrograde  movements  of  the  urinary 
branch  of  lymphntics  ;  and  by  parity  of  reafoning  the  variolous 
matter  is  abforbed,  and  fweils  the  face  and  hands  by  its  ftimulus. 

Variola  confluent.  The  confluent  fmall-pox  confifts  of  numer- 
ous puilules,  which  appear  on  the  third  day  of  the  fever,  flow 
to  Aether,  are  irregularly  circumfcribed,  flaccid,  and  little  eleva- 
ted j  the  fever  continuing  after  the  eruption  is  complete  ;  con- 

vulfions 


CLASS  II.  i.  3. 9.  OF  SENSATION.  103 

vulfions  do  not  precede  this  kind  of  fmall-pox,  and  are  To  far  to 
be  efteemed  a  favourable  fymptorn. 

The  confluent  fmall-pox  is  attended  with  fenfitive  inirrritatcd 
fever,  or  inflammation  with  arterial  debility  ;  whence  the 
ger  of  this  diieaie  is  owing  to  the  general  tendency  to  gangrene, 
with  petechke,  or  purple  fpots,  and  haemorrhages  •,  befides  the 
two  fources  of  danger  from  the  tumor  of  die  throat  about  the 
height,  or  eleventh  day  of  the  eruption,  and  the  purulent  fever 
after  that  time  ;  which  are  generally  much  more  to  be  dreaded 
in  this  than  in  the  diltincl  fmall-pox  described  above. 

M.  M.  The  method  of  treatment  muft  vary  with  the  degree 
and  kind  of  fever.  Venefeclion  may  be  ufed  in  the  dii. 
fmall-pox  early  in  the  difeafe,  according  to  the  ftrength  or  harci- 
nefs  of  the  pulfe  ;  and  perhaps  on  the  firft  day  of  the  confluent 
fmall-pox,  and  even  of  the  plague,  before  the  lenforial  power  is 
exhaulled  by  the  violence  of  the  arterial  aclion  ?  Cold  air,  and 
even  wafliing  or  bathing  in  cold  water,  is  a  powerful  means  in 
perhaps  all  eruptive  difeafes  attended  with  fever ;  as  the  q 
tity  of  eruption  depends  on  the  quantity  of  the  fever,  and 
activity  of  the  cutaneous  veflels  ;  which  may  be  judged  of  by 
the  heat  produced  on  the  fkin ;  and  which  latter  is  immediately 
abated  by  expofure  to  external  cold.  Mercurial  purges,  as  three 
grains  of  calomel  repeated  every  day  during  the  eruptive  fever, 
fo  as  to  induce  three  or  four  ftools,  contribute  to  abate  inflam- 
mation ;  and  is  believed  by  fome  to  have  a  fpecific  effect  on  the 
variolous,  as  it  is  fuppofed  to  have  on  the  venereal  contagion. 

It  has  been  faid,  that  opening  the  pock  and  taking  out  the 
matter  has  not  abated  the  fecondary  fever  ;  but  as  I  had  conceiv- 
ed, that  the  pits,  or  marks,  left  after  the  fmall-pox,  were  owing 
to  the  acrimony  of  the  matter  beneath  the  hard  fcabs,  which 
not  being  able  to  exhale  eroded  the  fkin,  and  produced  ulcers, 
I  directed  the  faces  of  two  patients  in  the  confluent  fmall-pox 
to  be  covered  with  cerate  early  in  the  difeafe,  which  was  daily 
renewed  ;  and  I  was  induced  to  think,  that  they  had  much  lefs 
of  the  fecondary  fever,  and  were  fo  little  marked,  that  one  of 
them,  who  was  a  young  lady,  almoft  entirely  preferred  her 
beauty.  Perhaps  mercurial  plafters,  or  cerates,  made  without 
turpentine  in  them,  might  have  been  more  efficacious  in  pre- 
venting the  marks,  and  efpecially  if  applied  early  in  the  difeafe, 
even  on  the  firft  day  of  the  eruption,  and  renewed  daily.  For 
it  appears  from  the  experiments  of  Van  Woenfel,  that  calomel 
or  corrofive  fublimate,  triturated  with  variolous  matter,  incapaci- 
tates it  from  giving  the  difeafe  by  inoculation.  Calomel  or 
fublimate  given  as  an  alterative  for  ten  days  before  inoculation, 
and  till  the  eruptive  fever  commences,  is  faid  with  certainty,  to 

render 


204  DISEASES  CLASS  II.  i.  3. 9; 

render  the  difeafe  mild  by  the  fame  author.     Exper.  on  Mercu- 
ry by  Van  Woenfel,  tranflated  by  Dr.  Fowle,  Salifbury. 

C  .DefFarts,  in  the  fitting  of  the  French  national  inftitute  is  faid 
to  have  adduced  a  number  of  fads  to  prove,  that  the  natural 
fmall-pox  is  rendered  much  milder  by  the  ufe  of  mercurial  rem- 
edies ;  which  I  fuppofe  is  probably  true,  as  mercurials  increafe 
the  abforption  in  many  other  ulcers,  and  confequently  diminifh 
the  acrimony  of  the  matter,  and  forward  their  healing. 

Variola  incculata.  The  world  is  much  indebted  to  the  great 
difcoverer  of  the  good  effects  of  inoculation,  whofe  name  is  un- 
known ;  and  our  own  country  to  lady  Wortley  Montague  for 
its  introduction  into  this  part  of  Europe.  By  inferting  the  vario- 
3ous  contagion  into  the  arm,  it  is  not  received  by  the  tonfils,  as 
generally  happens,  I  fuppofe,  in  the  natural  fmall-pox  ;  whence 
there  is  no  dangerous  fwelling  of  the  throat,  and  as  the  puftules 
are  generally  few  and  diftincl:,  there  is  feldom  any  fecondary 
fever  ;  whence  thofe  two  fources  of  danger  are  precluded  5 
hence  when  the  throat  in  inoculated  fmall-pox  is  much  infla- 
med and  fwelled,  there  is  reafon  to  believe,  that  the  difeafe  had 
been  previoufly  taken  by  the  tonfils  in  the  natural  way  :  which 
alfo,  I  fuppofe,  has  generally  happened,  where  the  confluent 
kind  of  fmall-pox  has  occurred  on  inoculation. 

I  have  known  two  inftances,  and  have  heard  of  others,  where 
the  natural  fmall-pox  began  fourteen  days  after  the  contagion 
had  been  received  ;  one  of  thefe  inftances  was  of  a  countryman, 
•who  went  to  a  market-town  many  miles  from  his  home,  where 
he  faw  a  perfon  in  the  fmall-pox,  and  on  returning  the  fever 
commenced  that  day  fortnight :  the  other  was  of  a  child,  whom 
the  ignorant  mother  carried  to  another  child  ill  of  the  fmall-pox, 
on  purpofe  to  communicate  the  difeafe  to  it  ;  and  the  variolous 
fever  began  on  the  fourteenth  day  from  that  time.  So  that  in 
both  thefe  cafes  fever  commenced  in  half  a  lunation  after  the 
contagion  was  received.  In  the  inoculated  fmall-pox  the  fever 
generally  commences  on  the  feventh  day ;  or  after  a  quarter  of 
a  lunation  ;  and  on  this  circumftance  probably  depends  the 
greater  mildnefs  of  the  latter.  The  reafon  of  which  is  difficult 
to  comprehend  ;  but  fuppofing  the  facts  to  be  generally  as  above 
related,  the  flower  progrefs  of  the  contagion  indicates  a  greater 
inirritability  of  the  fyftem,  and  in  confequence  a  tendency  to 
malignant  rather  than  to  inflammatory  fever.  This  difference  of 
the  time  between  the  reception  of  the  infection  and  the  fever  in 
the  natural  and  artificial  fmall-pox  may  neverthelefs  depend  on 
its  being  inferted  into  a  different  feries  of  veffels  ;  or  to  fome  un- 
known effect  of  lunar  periods.  It  is  a  fubject  of  great  curiofity, 
and  defervcs  further  inveftigation. 

Whca 


CLASS  II.  i.  3.  9.        OF  SENSATION.  205 

When  the  inoculated  fmall-pox  is  given  under  all  the  moil  fa- 
vourable circumftances,  I  believe  lefs  than  one  in  a  thoufand 
milcarry,  which  may  be  afcribed  to  fome  unavoidable  accident, 
fuch  as  the  patient  having  previoufly  received  the  infection,  or 
being  about  to  be  ill  of  fome  other  difeafe.  Thofe  which  have  late- 
ly mifcarried  under  inoculation,  as  far  as  has  come  to  my  knowl- 
edge, have  been  chiefly  children  at  the  breatl ;  for  in  thefe  the 
habit  of  living  in  the  air  has  been  confirmed  by  fo  fhort  a  time, 
that  it  is  much  eafier  deftroyed,  than  when  thefe  habits  of  life 
have  been  eftablifbed  by  more  frequent  repetition.  See  Seel:. 
XVII.  3.  Thus  it  appears  from  the  bills  of  mortality  kept  in 
the  great  cities  of  London,  Paris,  and  Vienna,  that  out  of  every 
thoufand  children  above  three  hundred  and  fifty  die  under  two 
years  old.  (Kirkpatrick  on  Inoculation.)  Whence  a  ftrong 
reafon  againft  our  hazarding  inoculation  before  that  age  is  pafP- 
ed,  efpecially  in  crowded  towns  •,  except  where  the  vicinity  of 
the  natural  contagion  renders  it  neceflary,  or  the  convenience  of 
inoculating  a  whole  family  at  a  time  ;  as  it  then  becomes  better 
to  venture  the  lefs  favourable  circumftances  of  the  age  of  the  pa- 
tient, or  the  chance  of  the  pain  from  toothing,  than  to  rifk  the 
infection  in  the  natural  way. 

The  mod  favourable  method  confifts  in,  firft,  for  a  week  be- 
fore inoculation,  reftraining  the  patients  from  all  kinds  of  fer- 
mented or  fpirituous  liquor,  and  from  animal  food  ;  and  by  giv- 
ing them  from  one  grain  to  three  or  four  of  calomel  every  oth- 
er day  for  three  times.  But  if  the  patients  be  in  any  the  leaft 
danger  of  taking  the  natural  infection,  the  inoculation  had  bet- 
ter be  immediately  performed,  and  this  abftinence  then  begun ; 
and  two  or  three  gentle  purges  with  calomel  fliould  be  given, 
one  immediately,  and  on  alternate  days.  Thefe  cathartics 
fhould  not  induce  more  than  two  or  three  ftools.  I  have  feen 
two  inftances  of  a  confluent  fmali-pox  in  inoculation  following 
a  violent  purging  induced  by  too  large  a  dole  of  calomel. 

Secondly,  the  matter  ufed  for  inoculation  {hould  be  in  a  fmall 
quantity,  and  warm,  and  fluid.  Hence  it  is  beft  when  it  can 
be  recently  taken  from  a  patient  in  the  difeafe  j  or  otherwife  it 
may  be  diluted  with  part  of  a  drop  of  warm  water,  fince  its  flu- 
idity is  likely  to  occailon  its  immediate  abforption  ;  and  the 
wound  mould  be  made  as  fmall  and  fuperficial  as  poilible,  as 
otherwife  ulcers  have  been  fuppofed  fometimes  to  enfue  with 
fubaxillary  abfceiTes.  Add  to  this,  that  the  making  two  punc- 
tures either  on  the  fame  or  one  on  each  arm,  fecures  the  fuccefs 
of  the  operation  in  refpeft  to  communicating  the  infeclion. 

Thirdly,  at  the  time  of  the   fever  or  eruption,  the  application 
of  cool  air  to  thofc  parts  of  the  ikin  which  are  too  warm,  or  ap- 
pear 


26<5  DISEASES  CLASS  II.  i.  3. 9," 

pear  red,  or  are  covered  with  what  is  termed  a  rafh,  fliould  be 
ufed  freely,  as  well  as  during  the  whole  difeafe.  And  at  the 
fame  time,  if  the  feet  or  hands  are  colder  than  natural,  thefe 
fhould  be  covered  with  flannel.  See  Clafs  IV.  2.  2.  10. 

Where  the  matter  ufed  is  not  procured  quite  frefh,  the  man- 
ner of  preferving  it  iliould  be  nicely  attended  to  :  as  I  have  been 
informed  that  a  furgeon  procured  fome  matter  in  a  fluid  (late, 
about  a  tea-fpoonful,  which  had  been  kept  fome  time  in  a  quill, 
and  afterwards  in  a  fmail  phial,  which  he  carried  fixteen  hours  in 
his  breeches-pocket  ;  with  this  he  inoculated  many  children, 
moft  of  whom  had  not  the  fmall-pox  in  confequence,  but  were 
affected  with  typhus,  one  of  whom  died.  Whence  it  appears, 
that  the  variolous  matter 'had  undergone  by  putrefaction  a  de- 
compofition,  and  that  another  kind  of  contagious  material  had 
been  produced  ;  which  agrees  with  the  ingenious  obfervations 
of  Dr.  Jenner,  in  his  treatifes  on  the  variolre  vaccinse,  or  cow- 
pox  ;  and  of  Mr.  Kite,  related  in  the  Memoirs  of  the  Medical 
Society  of  London,  Vol.  IV. 

May  not  the  confluent  fmall-pox  proceed  from  the  contagious 
matter  having  undergone  a  partial  putrefaction,  fo  as  to  contain 
both  the  variolous  and  the  typhus  contagion  ?  and  that,  whether 
the  difeafe  be  taken  naturally  or  by  inoculation  ?  and  that  hence 
the  confluent  kind  confiils  of  the  fmall-pox,  with  the  fever  com- 
monly termed  putrid  ?  and  that,  laftly,  as  Dr.  Jenner  obferves, 
xvhere  the  fmall-pox  has  been  faid  to  recede,  or  not  to  rife,  the 
difeafe  has  been  fimply  a  malignant  or  typhus  fever,  febris  fenfa- 
tivn.  inirritata,  miitaken  for  the  fmall-pox  ? 

Variola  vaccina.  Cow-pox.  Cows  are  liable  to  an  eruption 
on  their  paps  or  udders,  in  fome  counties,  as  in  Glouceftermire  ; 
which  was  occafionally  communicated  to  the  hands  or  arms  of 
thofe  who  milked  them,  producing  an  ulcer,  and  fome  degree  of 
fever :  and  it  had  been  long  obferved  by  the  people  of  thofe 
counties,  that  thofe  who  had  undergone  this  difeafe,  which  was 
called  the  cow-pox,  were  not  liable  to  the  fmall-pox. 

Dr.  Jenner,  an  eminent  phyfician  in  Gloucefterfhire,  fortu- 
nately attended  to  this  difeafe,  found  it  to  be  much  milder  than 
the  fmall-pox,  and  that  the  fact:  was  true,  that  it  fecured  thofe 
who  had  been  infected  with  it  from  afterwards  being  liable  to 
the  variolous  infection.  He  alfo  obferved,  that  the  vaccine-pox 
is  not  infectious,  but  by  careful  inoculation  ;  and  that,  on  this 
account,  it  might  be  inoculated  in  a  family,  without  endanger- 
ing others.  A  circumftance  of  great  confequence  to  the  public, 
as  the  inoculation  of  the  fmall-pox  is  known  frequently  to  prop- 
agate that  difeafe  ;  and  alfo  to  private  families,  when  there  hap- 
pens to  be  a  pregnant  woman  in  them,  who  has  not  had  the 

fmall-pox  : 


CLASS  II.  i.  3.  9.        OF  SENSATION.  207 

f mall-pox  :  to  all  whom  in  that  fituation  it  is  dangerous,  as  it 
generally  produces  mifcarriage,  and  frequently  death.  Dr. 
Cappe,  in  an  ingenious  paper  in  the  York  Herald,  obferves,  that 
the  vaccine  difeafe  is  never  communicated  but  by  contact,  and 
then  only  when  the  matter  lies  on  the  broken  ikin  -9  and  that 
many  women  during  pregnancy  have  paffed  through  this  dif- 
eafe,  and  none  have  fuffered  from  it  ;  and  that  inftead  of  behi£ 
peculiarly  dangerous  to  young  infants,  as  the  fmall-pox  is,  it 
feems  to  be  peculiarly  mild  to  them. 

From  all  thefe  circumftances  it  may  be  hoped,  that  the  inoc- 
ulation of  the  cow-pox  may  become  fo  general,  and  performed 
fo  early  in  life,  as  totally  to  eradicate  the  fmall-pox  ;  by  which 
latter  difeafe  above  two  thoufand  perfons  are  (hewn  by  Dr. 
Cappe,  by  the  bills  of  mortality,  to  be  annually  deftroyed  in  a 
part  of  London  only. 

As  the  cow-pox  is  fo  much  lefs  infectious  than  the  fmall-pox, 
it  requires  much  more  care  in  the  inoculation  to  give  the  difeafe 
with  certainty  ;  whence  it  fometimes  has  happened,  that  a  flight 
inflammation  from  the  puncture  of  the  lancet  has  been  miftaken 
by  the  unfkilful  for  the  vaccine  difeafe  :  and  I  have  heard  of  four 
fuch  patients  in  this  country  who  have  afterward  taken  the 
fmail-pox.  But  as  Dr.  Woodville  inoculated  a  thoufond  people 
with  the  fmall-pox,  who  had  previoufly  received  the  cow-pox, 
without  one  of  them  taking  the  infection,  there  can  be  no  doubt 
but  that  the  four  patients  above  mentioned  had  not  previoufly 
undergone  the  vaccine  difeafe  ;  and  ought  not  therefore  to  dif- 
credit  this  fortunate  and  wonderful  difcovery. 

In  the  counties  where  the  cows  are  fubject  to  this  difeafe,  the 
milking  is  performed  principally  by  men-fervants  ;  and  it  is 
there  believed,  as  Dr.  Jenner  mentions,  that  the  difeafe  was  pre- 
vioufly given  to  the  paps  of  the  cows  by  the  hands  of  the  men 
who  milked  them,  and  who  had  previoufly  acquired  the  infec- 
tious matter  from  the  heels  of  horfes,  which  difcharged  an  acrid 
fames,  when  they  had  a  difeafe  called  the  greafe.  This  may  be 
worth  further  investigation  ;  as  the  prefervation  of  people  from 
the  fmall-pox,  by  their  having  undergone  the  cow-pox,  is  fo  won. 
derful  a  phenomenon,  fo  contrary  to  our  previous  knowledge  of 
any  analogy  between  the  infectious  difeafes  of  men  and  quadru- 
peds, that  other  facts  equally  furprifing  may  exift.  May  not  the 
fmall-pox  have  been  originally  acquired  from  the  cow-pox  ? 
which  latter,  having  been  a  much  older  difeafe,  may  by  procefs 
of  time  have  become  milder  than  the  former  :  as  the  fmall-pox 
is  believed  alfo  to  have  become  much  milder  than  formerly  ;  ow- 
ing probably  to  the  incapacity  of  receiving  it,  which  exifls  in 
thofe  who  have  undergone  that  diicaie,  having  in  procefs  of  time 

become 


DISEASES  GLASS  IL  i.  3.  10; 

become  hereditary.  Which  incapacity  of  receiving  a  lecon'd 
time  the  {"mall-pox  may  be  explained  from  the  general  law  of  an- 
imation, that  ftimuli  greater  than  natural  lofe  their  effect  by 
habit,  or  from  their  being  too  violently  or  too  frequently  applied. 
As  the  cow-pox  is  faid  to  be  fo  favourable  to  infants,  great 
benefit  might  accrue  to  mankind  by  their  early  inoculation, 
-which  might  in  time  exterminate  the  fmall-pox.  This  might 
be  perhaps  effected  by  eftablifhing  a  difpenfary  in  towns,  and 
even  villages,  and  allowing  a  premium  of  a  few  (hillings  to  eve- 
ry one  of  the  poor  who  mould  be  thus  inoculated,  as  well  as  their 
daily  fuitenance  for  eight  or  ten  days,  that  their  arms  might  be 
infpedted  by  a  furgeon,  to  afcertain  that  they  underwent  the 
genuine  difeafe. 

10.  Rubeola  irritata,  morbilli.  The  meafles  commence  with 
fneezing,  red  eyes,  dry  hoarfe  cough,  and  are  attended  with  fen- 
fitive  irritated  fever.  On  the  fourth  day,  or  a  little  later,  fmall 
thick  eruptions  appear,  fcarcely  eminent  above  the  .fkin,  and,  af- 
ter three  days,  changing  into  very  fmall  branny  fcales. 

As  the  contagious  material  of  the  fmall-pcrx  may  be  fuppofed 
to  be  diffufed  in  the  air  like  a  fine  dry  powder,  and  mixing  with 
the  faliva  in  the  mouth  to  infect  the  toniils  in  its  paffage  to  the 
ftomach  ;  fo  the  contagious  material  of  the  meafles  may  be  fuppo- 
fed to  be  more  completely  diflblved  in  the  air,  and  thus  to  impart 
its  poifon  to  the  membrane  of  the  noftrils,  which  covers  the  fenfe 
of  imell  ;  whence  a  catarrh  with  fneezing  ufhers  in  the  fever  ; 
the  termination  of  the  nafal  duel:  of  the  lachrymal  fac  is  fubject 
to  the  fame  flimulus  and  inflammation,  and  affects  by  fympathy 
the  lachrymal  glands,  occafioning  a  great  flow  of  tears.  See 
Sect.  XVI.  8.  And  the  rednefs  of  the  eye  and  eyelids  is  pro- 
duced in  confequence  of  the  tears  being  in  fo  great  quantity, 
that  the  faline  part  of  them  is  not  entirely  Teabforbed.  See 
Sea.  XXIV.  2.  8. 

The  contagion  of  the  meafles,  if  it  be  taken  a  fufficient  time 
before  inoculation,  fo  that  the  eruption  may  commence  before 
the  variolous  fever  comes  on,  ftops  the  progrefs  of  the  fmall-pox 
in  the  inoculated  wound,  and  delays  it  till  the  meafle-fever  has 
finifhed  its  career.  See  Sedt.  XXXIII.  2.  9. 

The  meafles  are  ufually  attended  with  inflammatory  fever 
with  ftrong  pulfe,  and  bear  the  lancet  in  every  ftage  of  the  dif- 
eafe. In  the  early  periods  of  it,  venefection  renders  the  fever 
and  cough  lefs ;  and,  if  any  fymptoms  of  peripneumony  occur, 
is  repeatedly  neceffary  ;  and  at  the  decline  of  the  difeafe,  if  a 
cough  be  left  after  the  eruption  has  ceafed,  and  the  fubfequent 
branny  fcales  are  falling  of,  venefection  mould  be  immediately 
uied  j  which  prevents  the  danger  of  confumption.  At  this  time 

alfo 


CLASS  II.  i.  3.  n.       OF  SENSATION.  209 

aifo  change  of  air  is  of  material  confequence,  and  often  removes 
the  cough  like  a  charm,  as  mentioned  in  a  fimilar  iuuation  at 
the  end  of  the  chin-cough. 

Rubeola  inlrntata.  Meafles  with  inirritated  fever,  or  with 
weak  pttlfe,  has  been  fpoken  of  by  fome  writers.  See  London 
Med.  O'bferv.  Vol.  IV.  Art.  XL  It  has  alfo  been  faid  to  have 
been  attended  with  fore  throat.  Eduib.  Effays,  Vol.  V.  Art.  II. 
Could  the  fcarlet  fever  have  been  miflaken  for  the  meafles  ?  or 
might  one  of  them  have  fucceeded  the  other,  as  in  the  mcafles 
and  fmall-pox  mentioned  in  Seel:.  XXXIII.  2.  9.  ? 

From  what  has  been  faid,  it  is  probable  that  inoculation  might 
difarm  the  meafles  as  much  as  the  fmall-pox,  by  preventing  the 
catarrh,  and  frequent  pulmonary  inflammation,  which  attends 
this  difeafe  •,  both  of  which  are  probably  the  confequence  of 
the  immediate  application  of  the  contagious  miafmata  to  theic 
membranes.  Some  attempts  have  been  made,  but  a  difficulty 
feems  to  arife  in  giving  the  difeafe  ;  the  blood,  I  conjecture, 
would  not  infect,  nor  the  tears  ;  perhaps  the  mucous  difcharge 
from  the  noftrils  might  fucceed  ;  or  a  drop  of  warm  water  put 
On  the  eruptions,  arid  fcraped  off  again  with  the  edge  of  a  lan- 
cet ;  or  if  the  brariny  fcales  were  collected,  and  moillened  with 
a  little  warm  water  ?  Further  experiments  on  this  fubject  would 
be  worthy  the  public  attention. 

1 1.  Scarlatina  mitis.  The  fcarlet  fever  exifts  with  all  decrees 
of  virulence,  from  a  flea-bite  to  the  plague.  The  infectious 
material  of  this  difeafe,  like  that  of  the  fmall-pox,  I  fuppofe  to 
be  diffufed,  not  diffoived,  in  the  air ;  on  which  account  I  fui- 
pecl:  that  it  requires  a  much  nearer  approach  to  the  lick  for  a 
well  perfon  to  receive  the  infection,  than  in  the  me;i!!i>. ;  the 
contagion  of  which  I  believe  to  be  more  volatile,  or  diffufible, 
in  the  atmofphere.  But  as  the  contagious  miafmata  of  fmall- 
pox  and  fcarlet  fever  are  fuppofed  to  be  m#re  fixed,  they  may 
remain  for  a  longer  time  in  clothes  or  furniture  ;  as  a  thread  dip- 
ped in  variolous  matter  has  given  the  difeafe  by  inoculation  after 
having  been  expofed  many  days  to  the  air,  and  after  having  been 
kept  many  months  in  a  phial.  This  alfo  accounts  for  the  flow  or 
fporadic  progrefs  of  the  fcarlet  fever,  as  it  infects  others  at  but 
a  very  fmall  diftance  from  the  lick  ;  and  does  not  produce  a 
quantity  of  pus-like  matter,  like  the  fmall-pox,  which  can  ad- 
here to  the  clothes  of  the  attendants,  and  when  dried  is  hao!o 
to  be  (haken  off  in  the  form  of  powder,  and  thus  propagate  the 
infection. 

This  contagious  powder  of  the  fmai!-pox,  and  of  the  fcarlet 
fever,  becomes  mixed  with  filiva  in  the  mouth,  and  is  thus  car- 
ried to  the  tonfils,  the  mucus  of  which  arrefts  fome  paiuacs  of 

VOL.  II.  D  i> 


DISEASES  CLASS  II.  i.  3.  i •«, 

this  deleterious  material ;  while  other  parts  of  it  are  carried  into 
the  ftomach,  and  are  probably  decompofed  by  the  power  of  dt- 
geftion  ;  as  feems  to  happen  to  the  venom  of  the  viper,  when 
taken  into  the  ftomach.  Our  perception  of  bad  taftes  in  our 
mouths,  at  the  fame  time  that  we  perceive  difagreeable  odours 
to  our  noftrils,  when  we  inhale  very  bad  air,  occafions  us  to  fpit 
out  our  faliva ;  and  thus  in  fome  inftances,  to  preferve  ourfelves 
from  infection.  This  has  been  fuppofed  to  originate  from  the 
fympathy  between  the  organs  of  tafle  and  fmell;  but  any 
one  who  goes  into  a  fick-room  clofe  (hut  up,  or  into  a  crowded 
aflembly-room,  or  tea-room,  which  is  not  fufficiently  ventilated, 
may  eafily  mix  the  bad  air  with  the  faliva  on  his  tongue  fo  as  to 
tafte  it ;  as  I  have  my felf  frequently  attended  to. 

Hence  it  appears  that  thefe  heavy  infectious  matters  are  more 
liable  to  mix  with  the  faliva,  and  inflame  the  tonfils,  and  that 
cither  before  or  at  the  commencement  of  the  fever  ;  and  this  is 
what  generally  happens  in  the  fcarlet  fever,  always  I  fuppofe  in 
the  malignant  kind,  and  very  frequently  in  the  mild  kind.  But 
as  this  infection  may  be  taken  by  other  means,  as  by  the  ikin, 
it  alfo  happens  in  the  moft  mild  kind,  that  there  is  no  inflamma- 
tion of  the  tonfils  at  all ;  in  the  fame  manner  as  there  is  gener- 
ally no  inflammation  of  the  tonfils  in  the  inoculated  fmall-pox. 

In  the  mild  fcarlatina  on  the  fourth  day  of  the  fever  the  face 
fwells  a  little,  at  the  fame  time  a  florid  rednefs  appears  on  vari- 
ous parts  of  the  fkin  in  large  blotches,  at  length  coalefcing,  and 
after  three  days  changing  into  branny  fcales. 

M.  M.     Cool  air.     Fruit.     Lemonade.     Milk  and  water. 

Scarlatina  mallgna.  The  malignant  fcarlet  fever  begins  with 
inflamed  tonfils ;  which  are  fucceeded  by  dark  drab-coloured 
floughs  from  three  to  five  lines  in  diameter,  flat,  or  beneath  the 
furrounding  furface  ;  and  which  conceal  beneath  them  fpreading 
gangrenous  ulcers.  The  fweliings  of  the  tonfils  are  fenfible  to 
the  eye  and  touch  externally,  and  have  an  elaftic  rather  than  an 
cedematous  fee],  like  parts  in  the  vicinity  of  gangrenes.  The 
pulfe  is  very  quick  and  weak,  with  delirium,  and  the  patient 
generally  dies  in  a  few  days  \,  or  if  he  recovers,  it  is  by  flow  de- 
grees, and  attended  with  anafarca. 

M.  M.  A  vomit  once.  Wine.  Beer.  Cyder.  Opium. 
Bark,  in  frnall  repeated  dofes.  Small  fucceffive  blifters,  if  the 
extremities  are  cooler  than  natural.  Cool  air  on  the  hot  parts 
of  the  fkin,  the  cool  extremities  being  at  the  fame  time  covered. 
Iced  lemonade.  Broth.  Cufhrds.  Milk.  Jellies.  Bread 
pudding.  Chicken.  Touch  the  ulcers  with  a  dry  fponge  to 
abforb  the  contagious  matter,  and  then  with  a  fponge  filled  with 
vinegar,  with  or  without  iugar  of  lead  diflblved  iu  it,  about  fix 

grains 


CLASS  II.  i.  3.  12.      OF  SENSATION.  tit- 

grains  to  an  ounce  ;  or  with  a  very  little  blue  vitriol  diflblved  in 
it,  as  a  grain  to  an  ounce  ;  but  nothing  fo  inftantaneoufly  cor- 
re&s  the  putrid  fmell  of  ulcers  as  a  folution  of  alum,  about  half 
an  ounce  to  a  pint  of  water,  which  fhould  be  a  little  warmifh, 
and  injected  into  the  fauces  gently  by  means  of  a  fyringe.  Thefe 
fhould  be  repeated  frequently  in  a  day,  if  it  can  be  done  eafilyv 
and  without  fatigue  to  the  child.  A  little  powder  of  bark  taken 
frequently  into  tke  mouth,  as  a  grain  or  two,  -that  it  may  mix 
with  the  faliva,  and  thus  frequently  ftimulate  the  dying  ton- 
fils.  Could  a  warm  bath  made  of  deco&ion  of  bark,  or  a 
cold  alluviation  with  it,  be  of  fervice  ?  Could  oxygene  gas  mix- 
ed with  common  air  ftimulate  the  languid  fyftem  ?  Small  elec- 
tric (hocks  through  the  tonfils  every  hour  ?  ether  frequently 
applied  externally  to  the  fwe41ed  tonfils  •? 

As  this  difeafe  is  attended  with  the  greateft  degree'of  debility, 
jmd  as  ft imulant  medicines,  if  given  in  quantity,  fo  as  to  produce 
more  than  natural  warmth,  contribute  to  expend  the  already  too 
much  exhaufted  fenforial  power  ;  it  appears,  that  there  is  noth- 
ing fo  neceflary  to  be  nicely  attended  to  as  to  prevent  any  un- 
neceflary  motions  of  the  fyftem  ;  this  is  beft  accomplished  by  the 
application  of  cold  to  tho  e  parts  of  the  fkin,  which  are  in  the 
leaft  too  hot.  Dr.  Mofman*  of  Bradford,  directed  a  boy  of 
eight  years  of  age,  who  was  very  hot,  and  covered  with  the  icar- 
let  eruption,  to  be  taken  naked  out  of  bed,  and  moiftened  his 
ikin  all  over  with  cold  vinegar,  by  means  of  a  fponge,  with  great 
and  good  event.  It  is  probable  that  cold  vinegar  might  dimin- 
ith  the  infiammation  and  confequent  heat  of  the  fkin  more  ef- 
fectually than  cold  water,  as  its  application  to  the  lips  renders 
them  pale,  probably  by  ftimulating  the  abibrbent  extremities  of 
the  veins  into  greater  action.  Annals  of  Medicine,  Vol.  IV. 
1 799.  Secondly,  that  the  exhibition  of  the  bark  in  fuch  quan- 
tity as  not  to  opprefs  the  ftomach  and  injure  digeftion,  is  next  to 
be  attended  to,  as  not  being  liable  to  increafe  the  actions  of  the 
fyftem  beyond  their  natural  quantity ;  and  that  opium  and  wine 
ihould  be  given  with  the  greateft  caution,  in  very  fmall  repeated 
quantity,  and  fo  managed  as  to  prevent,  if  poflible,  the  cold  fits  of 
fever  ;  which  probably  occur  twice  in  25  hours,obeying  the  luna- 
tions like  the  tides,  as  mentioned  in  Seel:.  XXXII.  6.  that  is, 
I  fuppofe,  the  cold  periods,  and  confequent  exacerbations  of  fe- 
ver, in  this  malignant  fcarlatina,  occur  twice  in  a  lunar  day  j 
which  is  about  ten  minutes  leis  than  2  5  hours  ;  fo  that  if  the 
commencement  of  one  cold  fit  be  marked,  the  commencement  of 
the  next  may  be  expected  (if  not  difturbed  by  the  exhibition  of 
or  opium, or  the  application  of  blifters)  to  occur  in  about 

twelve 


212  DISEASES  CLASS  II.  i.  3.  12. 

twelve  hours  and  a  half  from  the  Commencement  of  the  former  ; 
or  if  not  prevented  by  large  dofes  of  the  bark. 

No  one  could  do  an  act  more  beneficial  to  fociety,  or  glorious 
to  himfelf,  than  by  teaching  mankind  how  to  inoculate  this  fa- 
tal difsafe  ;  and  thus  to  deprive  it  of  its  malignity.  Matter 
might  be  taken  from  the  ulcers  in  the  throat,  which  would  prob- 
ably convey  the  contagion  *,  or  warm  water  might  be  put  on  the 
eruption,  and  fcraped  off  again  by  the  edge  of  a  lancet.  Thefe 
experiments  could  be  attended  with  no  danger,  and  fhould  be 
tried  for  the  public  benefit,  and  the  honour  of  medical  fcience. 

Dr.  Harwood,  profeflbr  of  anatomy,  at  Cambridge,  favoured 

me  with  the  following  curious  cafe  of  this  infection  :  Mr.  N 

had  a  violent  delirium  in  the  fcnrlet  fever,  with  the  {kin  cracked 
in  many  places,  exuding  an  ichorous  matter  ;  he  was  attended 
by  a  poor  man  who  had  recently  cut  his  hand  with  a  glafs  bottle, 
and  in  the  ftruggle  of  confining  him  to  bed  his  wounded  hand 
•was  frequently  applied  to  the  patient's  body.  This  happened 
on  the  Friday  night  j  his  hand  was  inflamed  and  the  arm  i  well- 
ed the  next  day  ;  pn  the  Monday  following  he  was  feized  with 
the  fame  fever,  and  died  on  the  Wednefday  morning  after.  This 
would  feem  to  (hew,  as  far  as  a  fmgle  cafe  can  be  relied  on,  that 
the  fcarlet  fever  may  be  communicated,  like  the  fmall-pox,  by 
inoculation,  and  probably  with  fimilar  fuccefs,  if  the  matter  be 
diluted  with  warm  water,  ufed  in  fmall  quantity,  and  by  fuper- 
ficial  incifions  only,  through  the  cuticle. 

12.  Miliaria.  Miliary  fever.  An  eruption  produced  by  the 
warmth,  and  more  particularly  by  the  ftimulus,  of  the  points 
of  the  wool  in  flannel  or  blankets  applied  to  the  (kin,  has  been 
frequently  obferved  ;  which,  by  cool  drefs,  and  bed-clothes  with- 
out flannel,  has  foon  ceafed.  See  Clafs  I.  i.  2.  3.  This,  which 
may  be  called  miliaria  fudatoria>  has  been  confounded  with  other 
miliary  fevers,  and  has  made  the  exiftence  of  the  latter  doubted. 
Two  kinds  of  eruptions  I  have  feen  formerly  attended  with  fe- 
ver, but  did  not  fufficiently  mark  their  progrefs,  which  I  con- 
ceived to  be  miliary  eruptions,  one  with  arterial  ftrength,  or 
with  fenfitive  irritated  fever,  and  the  other  with  arterial  debility, 
or  with  fenfitive  inirritated  fever. 

In  the  former  of  thefe,  or  miliaria  irritata,  the  eruptions  were 
diflincl:  and  larger  than  the  fmall-pox,  and  the  fever  was  not  fub- 
dued  without  two  or  three  venefedHons,  and  repeated  cathartics 
with  calomel. 

The  latter,  or  miliaria  inirritata,  was  attended  with  great  ar- 
terial debility  ;  and  during  the  courfe  of  the  fever  pellucid  points 
appeared  within  the  fkin,  particularly  on  the  foft  parts  of  the 
fingers.  And,  in  one  patient,  whom  I  efteemed  near  her  end, 


CLASS  II.  i.  3.  13.      OF  SENSATION. 

I  well  recolleft  to  have  obferved  rpund  pellucid  globules,  like 
\vhat  are  often  feen  on  vines  in  hot-houtes,  no  larger  than  the 
fmalleft  pins'  heads,  adhere  to  her  neck  and  bofom  ;  which  were 
to  the  touch,  but  were  eafily  rubbed  off.  Thefe  difeafes, 
if  they  are  allied,  do  not  differ  more  than  the  kinds  of  fmall-pox  ; 
but  require  many  further  obfervations. 

The  eruption  Vo  often  feen  on  children  in  the  cradle,  and  call- 
ed by  the  nurfes  red-gum,  and  which  is  attended  with  fome  de- 
gree of  fever,  I  fufpeft  to  be  produced  by  too  great  warmth,  and 
the  contact  of  flannel  next  their  tender  (kins,  like  the  miliaria 
fudatoria ;  and  like  that  requires  cool  air,  cool  clothes,  and  lin- 
en next  their  ikin." 

13.  Peftis.  The  plague,  like  other  difeafes  of  this  clafs,  feems 
to  be  fometimes  mild,  and  fometimes  malignant ;  according  to 
the  teftimony  of  different  writers.  It  is  faid  to  be  attended 
with  inflammation,  with  the  greateil  arterial  debility,  and  to  be 
very  contagious,  attended  at  an  uncertain  time  of  the  fever  with 
buboes  and  carbuncles.  Some  authors  affirm,  that  the  conta- 
gion of  the  plague  may  be  repeatedly  received,  fo  as  to  produce 
the  difeafe  ;  but  as  this  is  contrary  to  the  general  analogy  of  all 
contagious  clifeafes,  which  are  attended  with  fever,  and  which 
cure  themfelves  fpontaneoufly  •,  there  is  reafon  to  fufpecl:,  that 
where  it  has  been  fuppofed  to  have  been  repeatedly  received, 
fome  other  fever  with  arterial  debility  has  been  miftaken  for  it, 
as  has  probably  univerfally  been  the  cafe,  when  the  fmall-pox 
has  been  faid  to  have  been  twice  experienced. 

M.  M.  Venefeftion  has  been  recommended  by  fome  writers 
on  the  firft  day,  where  the  inflammation  was  fuppofed  to  be  at- 
tended with  fufficient  arterial  flrength,  which  might  perhaps 
fometimes  happen,  as  the  bubo  feems  to  be  a  fuppuration  ;  but 
the  carbuncle,  or  anthrax,  is  a  gangrene  of  the  part,  and  (hews 
the  greateft  debility  of  circulation.  Whence  all  the  means  be- 
fore enumerated  in  this  genus  of  difeafes  to  fupport  the  powers 
of  life  are  to  be  adminiftered.  Currents  of  cold  air,  cold  water, 
ice,  externally  on  the  hot  parts  of  the  fkin. 

The  methods  of  preventing  the  fpreading  of  this  difeafe  have 
been  much  canvaffed,  and  feem  to  confift  in  preventing  all  con- 
gregations of  the  people,  as  in  churches,  or  play-houfes ;  and  to 
remove  the  fick  into  tents,  on  fome  airy  common,  by  the  fide  of 
a  river,  and  fupply  them  with  freih  food,  both  animal  and  veg- 
etable ;  with  beer  and  wine,  in  proper  quantities  ;  and  to  encour- 
age thofe  who  can,  daily  to  waih  both  their  clothes  and  them- 
felves. 

The  pejl'is  vnccina,  or  difeafe  amongfl  the  cows,  which  afflict- 
ed this  ilhnd  about  half  a  century  ago,  feems  to  have  been  a 

contagious 


2H  DISEASES  CLASS  II.  i.  3.  14, 

contagious  fever,  with  great  arterial  debility ;  as  in  fome  of  them, 
in  the  latter  ftage  of  the  difeafe,  an  emphyfema  could  often  be 
felt  in  fome  parts,  which  evinced  a  confiderable  progrefs  of  gan-^ 
grene  beneath  the  Ikin.  In  the  fenfitive  inirritated  fevers  of 
tliefe  animals,  I  fuppofe  about  fixty  grains  of  opium,  with  two 
ounces  of  extract  of  oak-bark,  every  fix  hours,  would  fupply 
them  with  an  efficacious  medicine  ;  to  which  might  be  added 
thirty  grains  of  vitriol  of  iron,  if  any  tendency  to  bloody  urine 
fhould  appear,  to  which  this  animal  is  liable.  The  method  of 
preventing  the  infection  from  fpreading,  if  it  fhould  ever  again 
gain  accefs  to  this  ifland,  would  be  immediately  to  obtain  an  or- 
der from  government  to  prevent  any  cattle  from  being  removed, 
which  were  found  within  five  miles  of  the  place  fuppofed  to  be 
infecled,  for  a  few  days  j  till  the  certainty  of  the  exillence  of 
the  peftilence  could  be  afcertained,  by  a  committee  of  medical 
people.  As  foon  as  this  was  afcertained,  all  the  cattle  within 
five  miles  of  the  place  mould  be  immediately  flaughtered,  and 
confumed  within  the  circumfcribed  diflricl: ;  and  their  hides  put 
Into  lime-water  before  proper  infpec"tors. 

14.  Pemphigus  is  a  contagious  difeafe,  attended  with    blad- 
dery eruptions,  appearing,  on  the  fecond  or  third  day,  as  large  as 
filberts,  which  remain  many  days,  and  then  effufe  a    thin  ichor. 
It  feems  to  be  either  of  a  mild  kind,  with  fenfitive  fever  only,  of 
which  I  have  feen  two  inilances ;  or  with  irritated,  or   with  in- 
irritated  fever  ;  as  appears  from  the  obfervations  of  M.  Salabert. 
See  Medical  Comment.     By  Dr.  Duncan,  Decad.  II.  Vol.  VI. 

15.  Varicella.     Chicken-pox  is  accompanied  with  fenfitive 
fever,  puftules  break  out  after  a  mild  fever,  like  the  fmall-pox, 
feldom  fuppurate,and  generally  terminate  in  fcales  without  fears. 
I  once  faw  a  lady  who  mifcarried  during  this  difeafe,  though  all 
her  children  had  it  as  fiightly   as  ufual.     It    fometimes  leaves 
fears  or  marks  on  the  fkin.     This  difeafe  has  been  miflaken  for 
the  fmall-pox,  and  inoculated  for  it ;  and  then  the  fmall-pox  has 
been  fuppofed  to  happen  twice  to  the  fame  perfon.     See  Tranf. 
of  the  College,  London.     It  is  probable  that  the  pemphigus  and 
urticaria,  as  well  as  this  difeafe,  have  formerly  been  difeafes    of 
more  danger ;   which  the  habit  of  innumerable  generations  may 
have  rendered  mild,  and  will  in  procefs  of  time  annihilate.     In 
the  fame  manner  as  the  fmall-pox,  venereal  difeafe,  and  rickets, 
feem  to  become  milder  or  lefs  in   quantity  every  half  century. 
While,  at  the  fame  time,  it  is  not  improbable,  that  other  new 
difeafes. may  arife,  and,  for  a  feafon,  thin  mankind  ! 

1 6.  Urticaria.     Nettle-ram  begins  with  mild  fenfitive  fever, 
which  is  fometimes  fcarcely  perceptible.     Hence  this  eruption 
has  been  thought  of  two  forts,  one  with  and   the  other  without 

fever. 


CLASS  II.  i.  3. 17.        OF  SENSATION. 

fever.  On  the  fecond  day  red  fpots,  like  parts  ftung  with  net. 
ties,  are  feen  ;  which  almoft  vanim  during  the  day,  and  recur  in 
the  evening  with  the  fever,  fucceeded  in  a  few  days  by  very  mi- 
nute fcales.  See  Tranf.  of  the  College,  London. 

17.  Aphtha.  Thrufh.  It  has  been  doubted,  whether  aphtha 
or  thrufh,  which  confifts  of  ulcers  in  the  mouth,  mould  be  enu- 
merated amongft  febrile  difeafes  ;  and  whether  thefe  ulcers  are 
always  fymptomatic,  or  the  confequence  rather  than  the  caufe  of 
the  fevers  which  attend  them.  The  tongue  becomes  rather 
fwelled  5  its  colour  and  that  of  the  fauces  purplifh ;  floughs  or 
ulcers  appear  firft  on  the  throat  and  edges  of  the  tongue,  and 
at  length  over  the  whole  mouth.  Thefe  floughs  are  whitifh, 
fometimes  diftincl:,  often  coalefcing,  and  remain  an  uncertain 
time.  Cullen.  I  fliall  concifely  mention  four  cafes  of  aphtha, 
but  do  not  pretend  to  determine  whether  they  were  all  of  them, 
fymptomatic  or  original  difeafes. 

Aphtha fenfttiva.  A  lady  during  pregnancy  was  frequently 
feized  with  ulcers  on  her  tongue  and  cheeks,  or  other  parts  of 
the  mouth,  without  much  apparent  fever  ;  which  continued  two 
or  three  weeks,  and  returned  almoft  every  month.  The  thrufh 
in  the  mouths  of  young  children  feems  to  be  a  fimilar  difeafe. 
Thefe  ulcers  refemble  thofe  produced  in  the  fea-fcurvy,  and  have 
probably  for  their  caufe  an  increafed  action  of  the  fecerning 
fyftem  from  increafed  fenfation,  with  a  decreafed  action  of  the 
abforbent  fyftem  from  decreafed  irritation.  See  Clafs  I.  2.  i.  14, 

M.  M.  Solutions  of  alum,  of  blue  vitriol.  Powder  of  bark 
taken  frequently  into  the  mouth  in  very  fmall  quantity.  See 
Clafs  II.  i.  3.  i. 

Aphtha  Irritata.  Inflammatory  aphtha.  A  cafe  of  this  kind 
is  related  under  the  title  of  fuppurative  rheumatifm.  Clafs  IV. 
2.  i.  16. 

Aphtha  inirritata.  Slotighs  or  ulcers  of  the  mouth,  attended 
•with  fenfitive  fever  with  great  arterial  debility.  They  feem  to 
fpread  downwards  from  the  throat  into  the  (lomach,  and  proba- 
bly through  the  whole  inteftinal  canal,  beginning  their  courfe 
•with  cardialgia,  and  terminating  it  with  tenefmus  ;  and/might 
perhaps  be  called  an  eryfipelas  of  this  mucous  membrane. 

M.  M.  Cool  air.  A  fmall  blifter  on  the  back.  Bark.  Wine. 
Opium  in  fmall  repeated  quantities.  Soap  neutralizes  the  gaf- 
tric  acid  without  cffervefcence,  and  thus  relieves  the  pain  of  car- 
dialgia, where  the  ftomach  is  affected.  Milk  alfo  deftroys  a  part 
of  this  acid.  Infufion  of  fage-leaves  two  ounces,  almond-foap 
from  five  grains  to  ten,  with  fugar  and  cream,  is  generally  both 
agreeable  and  ufefui  to  thefe  patients.  See  I.  2.  4.  5. 

Where  the  flomach  may  be  fuppofed  to  be  excoriated  by  poi- 

ibns 


£16  DISEASES  CLASSII.  i.-3.  ifc 

fons  containing  acid,  as  fublimate  of  mercury  or  arfenic  ;  or  if 
it  be  otherwife  inflamed,  or  very  fenfible  to  the  ftimuius  of  the 
gaftric  acid  j  or  where  it  abounds  with  acid  of  any  kind,  as  in 
cardialgia  •,  the  exhibition  of  fcap  is  perhaps  a  preferable  man- 
ner of  giving  alkali  than  any  other,  as  it  decompofes  in  the  itom- 
ach  without  effervefcencc  ;  while  the  cauftic  alkali  is  too  acrid  to 
be  adminiftered  in  iuch  cafes,  and  the  mild  alkali  produces  car- 
bonic gas.  If  a  drop  of  acid  of  vitriol  be  put  on  cap-paper,  it 
will  be  long  before  it  deftroys  the  paper  -,  but  if  a  drop  of  mild 
alkali  be  added,  a  iudden  effervefcence  arifes,  and  the  paper  is 
inftantly  deilroyed  by  the  efcape  of  the  fixed  air  j  in  the  fame 
manner  as  lumps  of  folid  lime  are  broken  into  powder  by  the  ef- 
cape of  the  fteam  produced  from  the  water,  which  is  poured  on 
them.  This  (hews  why  a  fucceffion  of  acid  and  of  alkaline  cauf-* 
tics  fooner  deftroys  a  part,  than  either  of  them  applied  feparately. 
1 8.  Dyfenteria.  Bloody-flux  is  attended  with  fenfitive  fever, 
generally  with  arterial  debility ;  with  frequent  mucous  or  bloody 
ftools,  which  contain  contagions  matter  produced  by  the  mem- 
branes of  the  inteftines  ;  the  alimentary  excrement  being  never- 
thelefs,  retained  ;  with  griping  pains,  and  tenefmus. 

Linneus  obferved  microfcopic  animals  in  the  ftools  of  dyfen- 
teric  patients,  and  concluded  from  thence  that  they  were  the 
caufe  of  the  difeafe  ;  in  the  fame  manner  the  animalcula,  feen 
by  microfcopes,  in  the  puftules  of  the  itch,  have  been  fuppofed 
to  be  the  caufe  of  thofe  eruptions.  See  Article  IV.  2.  i.  3. 
Thefe  animalcula  are  neverthelefs  feet!  in  almoft  all  animal  fluids 
which  have  for  a  time  ftagnated ;  as  in  the  femen,  and  in  all 
liquid  evacuations  from  the  inteftines,  as  aflerted  by  Buffon ; 
who  efteems  them  to  be  organized  beings,  though  not  perfect 
animals,  in  his  ingenious  treatife  on  generation.  Hiftoire  Nat- 
urel. 

M.  M.  Emetics.  Antimonials.  Peruvian  bark.  Opium 
and  calomel,  of  each  a  grain  every  night.  Bolus  armenire. 
Earth  of  alum.  Chalk.  Calcined  hartfhorn.  Mucilage.  Bee's 
wax  mixed  with  yolk  of  egg.  Cerated  glafs  of  antimony. 
Warm  bath.  Flannel  clothing  next  to  the  fkin.  Large  clyfters 
with  opium.  With  ipecacuanha,  with  fmoke  of  tobacco  ? 
Two  dyfenteric  patients  in  the  fame  ward,  of  the  infirmary  at 
Edinburgh,  quarrelled,  and  whipped  each  other  xvith  horfewhips 
a  long  time,  and  were  both  much  better  after  it,  owing  perhaps 
to  the  exertion  of  fo  much  of  the  fenforial  power  of  volition  ; 
which,  like  real  infanity,  added  excitement  to  the  whole  fyftem. 
The  prevention  of  this  contagion  muft  coniift  principally  in 
ventilation  and  cleanlinefs ;  hence  the  patients  fhould  be  re- 
moved into  cottages  diftant  from  each  other,  or  into  tents  ;  and 

their 


CLASS  II.  i.  3.  19.          OF  SENSATION.  217 

their  fseces  buried  as  foon  as  may  be  ;  or  conveyed  into  a  running 
ftream  ;  and  themfelves  fhould  be  xvafhed  with  cold  or  warm 
water  after  every  evacuation.  For  the  contagious  matter  confifts 
in  the  mucous  or  purulent  difcharge  from  the  membrane  which 
lines  the  inteftines ;  and  not  from  the  febrile  perfpiration,  or 
breath  of  the  patients.  For  the  fever  is  only  the  confequence 
and  not  the  caufe  of  contagion  ;  as  appears  from  Genus  the 
Fifth  of  this  Order,  where  contagion  exifts  without  fever. 

19.  Gaflritis  fuperficialis.      Superficial    inflammation    of  the 
ftomach.     An  eryfipelatous  inflammation  of  the  ftomach  is  men- 
tioned by  Dr.  Cullen  from  his  own  obiervations  \  which  is  dif- 
tinguimed  from  the  inflammatory  gaftritis  by  lefs  pain  and  fever, 
and  by  an  eryfipelatous  rednefs  about  the  fauces.     Does  this 
difeafe  belong  to  aphtha  ? 

20.  Enteritis  fuperficlalis.     Superficial   inflammation  of  the 
bowels  is  alfo  mentioned  by  Dr.  Cullen,  from  his  own  obferva- 
tion,  under  the  name  of  enteritis  erythematica  \  and  is  faid   to 
be  attended  with  lefs  pain  and  fever,  without  vomiting,  and  with 
diarrhoea.     May  not  this  difeafe  be  referred  to  aphtha,  or  to 
dyfentery  ? 


VOL.  II.  E  *  ORDO 


DISEASES  CLASS  II.  i.  4.  i, 

ORDO  I. 

Increafed  Senfation. 
GENUS  IV. 

^  Production   of  new   VeJJels   by   internal  Membranes  or 
Glands  y  •without  Fever. 

WHERE  inflammation  is  produced  in  a  fmall  part,  which  has 
not  great  natural  fenfibility,  the  additional  fenfation  does  not 
produce  an  increafed  action  of  the  arterial  fyftem ;  that  is,  the 
aflbciated  motions  which  are  employed  in  the  circulation  of  the 
blood  (thofe  for  inftanee  of  the  heart,  arteries,  glands,  capillaries, 
and  their  correfpondent  veins),  are  not  thrown  into  increafed  ac- 
tion by  fo  fmall  an  addition  of  the  fenforial  power  of  fenfation. 
But  when  parts  which  naturally  poflefs  more  fenfibility  become 
inflamed,  the  quantity  of  the  fenforial  power  of  fenfation  becomes 
fo  much  increafed,  as  to  afFecl  the  affociated  motions  belonging 
to  the  circulation,  occafioning  them  to  proceed  with  greater  fre- 
quency ;  that  is,  a  fever  is  induced.  This  is  well  exemplified 
in  the  internal  and  fuperfkial  paronychia  ;  one  of  which  is  at- 
tended with  great  pain  and  fever,  and  the  other  with  little  pain 
and  no  fever.  SeeClafs  II.  i.  2.  19.  and  II.  i.  4.  5. 

From  hence  it  appears,  that  the  fenfitive  fever  is  an  accident- 
al confequence  of  the  topical  phlegmon,  or  inflammation,  and 
not  a  caufe  of  it ;  that  it  is  often  injurious,  but  never  falutary  j 
and  lliould  therefore  always  be  extinguifhed,  as  foon  as  may  be, 
either  by  the  lancet  and  cathartics,  and  diluents,  and  cold  air, 
when  it  is  of  the  irritated  kind  ;  or  by  the  bark,  opium,  cool  air, 
and  nutrientia,  when  it  is  of  the  inirritated  kind. 

SPECIES. 

i.  Ophthalmia  fuperficialis .  As  the  membranes,  which  cover 
the  eye,  are  excluded  from  the  air  about  one  third  part  of  the 
twenty-four  hours,  and  are  moiftened  by  perpetual  nictitation 
during  the  other  fixteen,  they  may  be  confidered  as  internal 
membranes  ;  and,  from  the  analogy  of  their  inflammation  to 
that  of  other  internal  membranes,  it  is  arranged  under  this  ge- 
nus ;  whilft  the  tonfillitts  is  eileemed  an  inflammation  of  an  ex- 
ternal membrane,  becaufe  currents  of  air  are  perpetually  palling 
both  day  and  night  over  the  fauces. 

The  fuperficial  ophthalmy  has  generally  been  eileemed  a 

fymptom 


CLASS  II.  i.  4.  i.        OF  SENSATION.  219 

f ymptom  of  fcrofula,  when  it  recurs  frequently  in  young  per- 
fons;  but  is  probably  only  a  concomitant  of  that  difeafe,  as  a 
fymptom  of  general  debility  ;  ramifications  of  new  red  veffels, 
and  of  enlarged  old  ones,  are  fpread  over  the  white  part  of  the 
eye  ;  and  it  is  attended  with  lefs  heat,  lefs  pain,  and  lefs  intoler- 
ance of  light  than  the  ophthalmia  interna,  defcribed  in  Clafs  II. 
i.  2.  2.  It  occurs  in  thofe  of  feeble  circulation,  efpecially  chil- 
dren of  a  fcrofulous  tendency,  and  feems  to  arife  from  a  previ- 
ous torpor  of  the  veflels  of  the  tunica  albuginea  from  their  being 
expofed  to  cold  air  ;  and  from  this  torpor  being  more  liable  to 
occur  in  habits,  which  are  naturally  inirritable  ;  and  therefore 
more  readily  fall  into  quiefcence  by  a  fmaller  deduction  of  the 
ftimulus  of  heat,  than  would  affect  ftronger  or  more  irritable 
habits  ;  the  confequence  of  this  torpor  is  increafed  action,  which 
produces  pain  in  the  eye,  and  that  induces  inflammation  by  the 
acquifition  of  the  additional  fenforial  power  of  fenfation. 

Ophthalmia  lymphatica  is  a  kind  of  anafarca  of  the  tunica  adna- 
ta  ;  in  this  the  veflels  over  the  fclerotica,  or  white  part  of  the 
eye,  rife  confiderably  above  the  cornea,  which  they  furround,  are 
lefs  red  than  in  the  ophthalmia  fuperficialis,  and  appear  to  be 
f welled  by  an  accumulation  of  lymph  rather  than  of  blood  ;  it 
is  probably  owing  to  the  temporary  obilruclion  of  a  branch  of 
the  lymphatic  fyftem. 

M.  M.  If  the  pain  be  great,  yenefeftion  by  leeches  on  the 
temple,  or  cutting  the  temporal  artery,  and  one  purge  with  three 
or  four  grains  of  calomel  ihould  -be  premifed.  Then  the  Peru- 
vian bark  twice  a  day.  Opium  from  a  quarter  to  half  a  grain 
twice  a  day,  for  fome  weeks.  Bathe  the  eye  frequently  with 
cold  water  alone,  or  with  cold  water  to  a  pint  of  which  is  added 
half  an  ounce  of  fait.  White  vitriol,  fix  grains  difTolved  in  one 
ounce  of  water  ;  a  drop  or  two  to  be  put  between  the  eyelids 
twice  a  day.  Take  very  fmall  electric  fparks  from  the  eyes  eve- 
ry day  for  a  fortnight.  Bathe  the  whole  head  with  fait  and  wa- 
ter made  warm,  every  night,  for  fome  months.  Send  fuch  chil- 
dren to  a  fchool  near  the  fea,  for  the  convenience  of  fea- bathing, 
for  many  months,  annually  ;  fuch  fchools  are  to  be  found  in  or 
near  Liverpool. 

When  a  child  is  afflicted  with  an  inflamed  eye  of  this  kind, 
he  fhould  always  fit  with  his  back  to  the  window  or  candle  ; 
but  it  is  generally  not  neceflary  to  cover  it,  or  if  the  uneafy  fen- 
fation of  light  makes  this  proper,  the  cover  fhould  (land  off  from 
the  eye,  fo  as  not  much  to  exclude  the  cool  air  from  it.  As 
covering  an  eye  unneceflarily  is  liable  to  make  that  eye  weaker 
than  the  other,  from  its  not  being  fufficiently  ufed,  and  thenje 
to  produce  a  fquinrjng  forever  afterwards. 

Never  thelefs* 


220  DISEASES  CLASS  II.  i.  4. 2. 

Neverthelefs,  when  the  pain  is  great,  a  poultice  mud  be  ap- 
plied to  keep  the  eyes  moift,  or  a  piece  of  oiled  filk  bound  light- 
ly over  them.  Or  thus,  boil  an  egg  till  it  is  hard,  cut  it  longi- 
tudinally into  two  hemifpheres,  take  out  the  yolk,  few  the  backs 
of  the  two  hollow  hemifpheres  of  the  white  to  a  ribbon,  and 
bind  them  over  the  eyes  every  night  on  going  to  bed  •,  which,  if 
nicely  fitted  on,  will  keep  the  eyes  moilt  without  any  difagreea- 
ble  preflure.  See  Clafs  I.  i.  3.  14. 

Ophthalmia  equina.  An  inflammation  of  this  kind  is  liable  to 
affect  the  eyes  of  horfes  ;  one  cauie  of  which  is  owing  to  a  filly 
cuftom  of  cutting  the  hair  out  of  horfes'  ears  ;  by  which  they 
are  not  only  liable  to  take  cold  at  the  ear,  but  grafs-feeds  are  li- 
able to  fall  into  their  ears  from  the  high  racks  in  ftables  ;  and 
in  both  cafes  the  eye  becomes  inflamed  by  fympathy.  I  once 
directed  the  temporal  artery  of  a  horfe  to  be  opened,  who  had 
frequent  returns  of  an  inflamed  eye  ;  and  I  believed  it  was  of 
eflential  fervice  to  him  ;  it  is  probable  that  the  artery  was  after- 
wards contracted  in  the  wounded  part,  and  that  thence  lefs  blood 
was  derived  to  the  eye  :  the  haemorrhage  was  flopped  by  two 
perfons  alternately  keeping  their  fingers  on  the  orifice,  and  after- 
wards by  a  long  bandage  of  broad  tape. 

2.  Pterigion.     Eye-wing.     A  fpot  of  inflammation  fometimes 
begins  on  the  in  fide  of  the  lower  eyelid,  or  on  the  tunica  albu- 
ginea,  and  fpreads  an  intertexture  of  red  veflels  from  it,  as  from 
a  centre,  which  extend  on  the  white  part  of  the  eye,  and  have 
the  appearance  of  the  wing  of  a  fly,  from  whence  its  name. 

M.  M.  Cut  the  ramifications  of  veflels  again  and  again,  with 
the  point  of  a  lancet,  clofe  to  the  centre  of  inflammation.  Touch 
them  repeatedly  with  lunar  cauftic.  See  Home  on  the  urethra. 
Page  10 1. 

Mr.  Hadley  of  Derby  procured  an  ingenious  inftrument  to  be 
made  to  cut  the  veflels,  which  had  fpread  their  numerous 
branches  over  an  opaque  cornea,  after  a  violent  inflammation  ; 
by  which  they  were  repeatedly  divided,  with  little  pain  to  the 
patient,  as  there  was  no  neceflity  to  hold  them  by  a  forceps. 
The  instrument  v/as  in  the  form  of  a  corn-fickle,  or  the  early 
crefcent  of  the  new  moon,  about  an  inch  in  length,  the  inner 
edge  of  the  curve  was  (harp,  and  the  point  fine  ;  the  back  was 
rounded  and  fmooth,  and  the  other  end  fixed  in  an  ivory  han- 
dle. The  point  of  this  was  fuddenly  introduced  under  the 
branches  of  the  new  veiTels,  which  were  thus  cut  upwards,  and 
there  was  no  occafion  to  hold  the  eye,  or  the  trunks  of  the  veflels. 

3.  Tarfitis palpebrarum.     Inflammation   of  the   edges   of  the 
eyelids.     This  is  a  difeafe  of  the  glands,  which  produce  the  hairs 
pf  the  eyelafhes,  and  is  frequently  the  caufe  of  their  falling  off. 

After 


CLASS  II.. i.  4. 4.          OF  SENSATION.  ?.2t 

After  this  inflammation  a  hard  fear-like  ridge  is  left  on  the  • 
of  the  ev  :h  fcratches  and  ia  flames  the  eyeball,  and  be- 

•ry  troublefome  difeafe. 

Turkiih  ladies  are  faid  to  colour  the  edjje  of  the  f 
itimony  in  very  fiat  not  only:, 

lip.mond  fet  on  a  black  foil,  but  may  pre- 

t   "roni  being  reflected  from  thefe  edges  into 

:)fe  of  the  black  feathers  about 

:.   XXXIX.   5.    i.   and  may 

••eiids  from  being  inflamed  by  the 

:m.     Black  lead  in  fine  powder 

s  than  antimony,  and  might 

I's  "'air  brufli 

•intment   fmeared  at  night  on  the  edges 

!tYi    fixty   grains,  hog's   greafe  half  an 

j  an  ointment  to  be  fmeared  on   them  in 

t       './  .      Cold  water   irequentiy  in  the  day.     See  Clafs  II. 
i 

Stye.     This   inflammation   begins   either  on 

of  the  eye-lids,  or  in   the   looie  (kin  of  them, 

very  flow  either   in  coming  to  fuppuration  or 

in  d  The  (kin  beneath  the   lower  eyelid    is  the  moft 

••s   tumor,  which  ibmetimcs   never  fuppurates 

omes  an  encyfted  tumor :  for  as  this  {kin  is   very 

urpofe  of  admitting  great  motion  to  the  eyelid,  the 

abforbent  posver  of  the  veins  feems   particularly  weak   in  this 

part ;  \vhence  when  any  perfon  is  weakened  by  fatigue  or  other- 

wife,  a  darker  (hade  of  colour  is  feen  beneath  the  eyes  ;  \vhich 

is  o-.ving  to  a  lefs  energetic  atlioa  of  the  abforbent  terminations 

of  the  veins,  whence  the  currents  of  dark  or  venous   blood  are 

delayed  in  them.     This  dark  (hade  beneath  the  eyes,  when  it  is 

permanent,  is  a  fyrnptom  of  habitual  debility,  or  inirritability  of 

the  circulating  fyftem.     See  Clafs  I.   2.   2.   2. 

M.  M.  Smear  the  tumors  with  mercurial  ointment,  moiften 
them  frequently  with  ether..  To  promote  their  fuppuration  they 
may  be  wounded  with  a  lancet,  or  flit  down  the  middle,  or  they 
may  be  cut  out.  A  cauflic  leaves  a  large  fear.  • 

5.    Paronychia  fuperficialis.     Whitlow.      An  inflammai 
bout  the  roots  of  the   nail  beneath   the  ilcin,  which    fuppurates 
without  fever,  and  fometimes  deftroys  the  nail ;  which  is,  how- 
ever, gradually  reproduced.     This   kind  of  abfcefs,  though  not 
itfelf  dangerous,  has  given   opportunity  for  the  inoculation  of 
venereal  matter  in  the  hands  of  accoucheurs,  and  of  putrid  mat- 
ter  from  the  difleclion  of  difeafed  bodies  ;  and  has  thu.- 
caufe  of  difeafe    and  death.     When  putrid   matter    has  bee  a 

thus 


222  DISEASES  CLASS  II.  i.  4.  6, 

thus  abforbcd  from  a  dead  body,  a  livid  line  from  the  finger  to 
the  fwelled  gland  in  the  axilla  is  faid  to  be  vifible  ;  which  (hews  the 
inflammation  of  the  abforbent  veflel  along  its  whole  courfe  to  the 
lymphatic  gland  ;  and  death  has  generally  been  the  confequence. 

M.  M.  In  the  common  paronychia  a  poultice  is  generally 
fufficient.  In  the  abforption  of  putrid  matter  rub  the  whole 
hand  and  arm  with  mercurial  ointment  three  or  four  times  a 
day,  or  perpetually.  Could  the  fwelled  axillary  gland  be  exfecV 
ed  ?  In  the  abforption  of  venereal  matter  the  ufual  methods  of 
cure  in  fyphilis  muft  be  adminiftered, as  in  Clafs  II.  I.  5.  I. 

6.  Gutta  rofea.  The  rofy  drop  on  the  face  is  of  three  kinds. 
Firft  the  gutta  rofea  hepatica,  or  the  red  pimples  on  the  faces  of 
drunkards,  which  are  probably  a  kind  of  crifis,  or  vicarious  in- 
ii animation,  which  fucceeds,  or  prevents,  a  torpor  of  the  mem- 
branes of  the  liver.  This  and  the  fucceeding  fp^cies  properly 
belong  to  Clafs  IV.  i.  2.  14. 

Secondly,  the  pimpled  face,  in  confequence  of  drinking  cold 
water,  or  eating  cold  turnips,  ot  other  infipid  food,  when  much 
heated  with  exercife  ;  which  probably  arifes  from  the  fympathy 
between  the  Ikin  of  the  face  and  the  ftomach  ;  and  may  be  call- 
ed the  gutta  rofea  Jlomatlca.  Which  is  diftinguimed  from  the 
former  by  the  habits  of  the  patient  in  refpe6r,  to  drinking ;  by 
the  colour  of  the  eruptions  being  lefs  deep  ;  and  by  the  patient 
continuing  generally  to  be  troubled  with  fome  degree  of  apepfia. 
See  Clafs  I.  3.  i.  3.  I  knew  a  lady  who  had  long  been  afflict- 
ed with  pain  about  the  region  of  the  ftomach  ;  and,  on  drinking 
half  a  pint  of  vinegar,  as  a  medicine,  {he  had  a  breaking  out 
commenced  on  her  face  ;  which  remained,  and  fhe  became  free 
from  the  pain  about  the  ftomach.  Was  this  a  ftomachic,  or  an 
hepatic  difeafe  ? 

Thirdly,  there  is  a  red  face,  which  confifts  of  fmaller  pimples 
than  thofe  above  mentioned  ;  and  which  is  lefs  liable  to  fuppu- 
rate  ;  and  which  feems  to  be  hereditary,  or  at  leaft  has  no  appar- 
ent caufe  like  thofe  above  mentioned ;  which  may  be  termed 
gutta  rofea  hereditaria,  or  punfta  rofea. 

Mrs.  S.  had  a  pimpled  face,  which  I  believe  arofe  from  pota- 
tion of  ale.  She  applied  alum  in  a  poultice  to  it,  and  had  foon 
a  paralytic  ftroke,  which  difabled  her  on  one  fide,  and  termina- 
ted in  her  death. 

Mrs.  L.  had  a  red  pimpled  face,  which  feemed  to  have  been 
derived  from  her  mother,  who  had:  probably  acquired  it  by  vi- 
nous potation  ;  (lie  applied  a  quack  remedy  to  it,  which  I  believe 
was  a  folution  of  lead,  and  was  feized  with  epileptic  fits,  which 
terminated  in  palfy,  and  deftroyed  her.  This  (hews  the  danger 
of  ufmg  white  paint  on  the  face,  which  is  called  bifmuth,  but  is 

in 


CLASS  II.  i.  4.  6.        OF  SENSATION.  223 

in  reality  white  lead  or  ceruiTa  j  and  if  it  be  bifmuth,  it  may  be 
equally  deleterious. 

Mr.  Y had  acquired  the  gutta  rofea  on  hisnofe,  and  ap- 
plied a  faturnine  folution  on  it  for  a  few  nights,  and  was  then 
feized  with  paralyfis  on  one  fide  of  his  face  -,  which  however  he 
gradually  recovered,  and  has  fmce  acquired  the  gutta  rofea  on 
other  parts  of  his  face. 

Thefe  fatal  effects  were  probably  caufed  by  the  difagreeable 
fenfation  of  an  inflamed  liver,  which  ufed  before  to  be  relieved 
by  the  fympathetic  action  and  confequent  inflammation  of  the 
fkin  of  the  face,  which  was  now  prevented  by  the  (tronger  ftim- 
ulus  of  the  application  of  calx  of  lead.  The  manner  in  which 
difagreeable  fenfations  induce  epilepfy  and  palfy  is  treated  of  in 
Clafs  III.  In  fome  cafes  where  habitual  difcharges,  or  eruptions, 
or  ulcers,  are  flopped,  a  torpor  of  the  fyflem  may  follow,  owing 
to  the  want  of  the  accuftomed  quantity  of  fenfation  or  irritation. 
See  Clafs  I.  i.  2.  9.  and  II.  i.  5.6.  In  both  thefe  fituations 
fome  other  ftimulus  mould  be  ufed  to  fupply  the  place  of 
that  which  is  taken  away  •,  which  may  either  be  perpetual,  as  an 
iffue  ;  or  periodical,  as  a  cathartic  repeated  once  a  fortnight  or 
month. 

Mifs  W.  an  elegant  young  lady,  of  about  twenty,  applied  a 
mercurial  lotion  to  her  face,  which  was  covered  with  very  fmall 
red  points  (which  feemed  to  have  been  not  acquired  by  any 
known  or  avoidable  means) ;  (he  was  feized  with  inflammation  of 
her  lirer,  and,  after  repeated  bleeding  and  cathartics,  recovered  ; 
and  in  a  few  weeks  the  eruption  appeared  as  before. 

M.  M.  Five  grains  of  calomel  once  a  month,  with  a  cathar- 
tic, five  grains  of  rhubarb  and  a  quarter  of  a  grain  of  emetic  tar- 
tar every  night  for  many  weeks.  With  this  preparation  mer- 
curial plafters,  made  without  turpentine,  and  applied  every 
night, -and  taken  off  every  morning,  will  fometimes  fucceed,  and 
may  be  ufed  with  fafety.  But  bliftering  the  face  all  over  the 
eruption,  beginning  with  a  part,  fucceeds  better  than  any  other 
means,  as  I  have  more  than  once  experienced.- — Something  like 
this  is  mentioned  in  the  Letters  of  Lady  Mary  Wortley  Mon- 
tague, who  bliftered  her  face  with  balfam  of  Mecca. 

Mrs.  F.  had  for  many  years  had  a  difagreeably  looking  erup- 
tion on  her  chin.  After  a  cathartic  with  calomel,  (he  was  ad- 
vifed  to  blifter  her  whole  chin  ;  on  the  healing  of  the  blifter  a 
few  eruptions  again  appeare^,  which  ceafed  on  the  application 
of  a  fecond  blifter.  She  took  rhubarb  five  grains,  and  emetic 
tartar  a  quarter  of  a  grain  every  night  for  many  weeks. 

Mifs  L.  a  young  lady,  about  eighteen,  had  tried  variety  of  ad- 
vice, for  pimples  over  the  greateft  part  of  her  face,  in  vain.  She 

- 


*24  DISEASES  CLASS  II.  i.  4.  7. 

took  the  above  medicines  internally,  and  bliftered  her  face  by  de- 
grees all  over,  and  became  quite  beautiful.  A  fpot  or  two  now 
and  then  appeared,  and  on  this  account  flic  frequently  ilept  with 
parts  of  her  face  covered  with  mercurial  plafter,  made  without 
turpentine,  which  was  held'On  by  a  pafteboard  maflt,  and  taken 
off  in  the  mornings  ;  if  any  part  of  the  plafter  adhered,  a  little 
butter  or  oil  deftroyed  the  adhefion.  If  there  be  turpentine,  or 
any  other  native  balfam,  mixed  with  the  mercurial  plafter,  it  is 
very  liable  much  to  inflame  the  face  (I  fuppofe  like  the  balfam  of 
Mecca) ;  but  if  a  fmall  quantity  of  flour  of  brimftone  be  added, 
I  believe  it  will  readily  mix.  As'  a  mercurial  ointment  is  faid 
to  be  quickly  made  by  adding  only  fix  grains  of  flour  of  fulphur 
to  fix  drachms  of  mercury,  and  two  ounces  of  hog's  greafe. 

7.  Odontitis.  Inflammatory  tooth-ach  is  occafioned  by  in- 
flammation of  the  membranes  of  the  tooth,  or  a  caries  of  the 
bone  itfelf.  The  gum  fometimes  fuppurates,  otherwife  a  fwell- 
ing  of  the  cheek  fucceeds  by  aflbciation,  and  thus  the  violence 
of  the  pain  in  the  membranes  of  the  tooth  is  relieved,  and  fre- 
quently cured  ;  and  when  this  happens  the  difeafe  properly  be- 
longs to  Clafs  IV.  as  it  fo  far  refembles  the  tranflations  of  mor- 
bid actions  in  the  gout  and  rheumatifm. 

At  other  times  the  tooth  clies  without  caries,  efpecially  in  peo-» 
pie  about  fixty  years  of  age,  or  before  ;  and  then  it  ftimuiates  its 
involving  membrane,  like  any  other  extraneous  fubftance.  The 
membrane  then  becomes  inflamed  and  thickened,  occafioning 
fome  pain,  and  the  tooth  rifes  upwards  above  the  reft,  and  is 
gradually  pufhed  out  whole  and  undecayed ;  on  its  rifmg  up  a 
pus-like  mucus  is  feen  difcharged  from  the  gum  which  furrounds 
it ;  and  the  gum  feems  to  have  left  the  tooth,  as  the  fangs  or 
roots  of  it  are  in  part  naked. 

M.  M.  Where  the  tooth  is  found  it  can  only  be  faved  by 
evacuations,  by  venefeclion,  and  a  cathartic  ;  and  after  its  op- 
eration two  grains  of  opium.  A  blifter  may  alfo  be  ufed  behind 
the  ear,  and  ether  applied  to  the  cheek  externally.  In  (lighter 
cafes  two  grains  of  opium  with  or  without  as  much  camphor 
may  be  held  in  the  mouth,  and  fufFered  to  diflblve  near  the  af. 
fecled  tooth,  and  be  gradually  fwallowed.  See  Clafs  I.  2.  4. 
12.  Odontalgia  may  be  diftinguimed  from  otitis  by  the  appli- 
cation of  cold  water  to  the  affected  tooth  ;  for  as  the  pain  of 
common  tooth-ach  is  owing* to  torpor,  whatever  decreafes  ftimu- 
lus  adds  to  the  torpor  and  confequent  pain  ;  vrhereas  the  pain  of 
an  inflamed  tooth,  being  caufed  by  the  increafed  action  of  the 
membranes  of  it,  is  in  fome  meafure  alleviated  by  the  applica- 
tion of  cold. 

8.  Otitis.     Inflammation  and  confequent  fuppuration  of  fome 

membranes 


CLASS  II.  i,  4- 9      *  OF  SENSATION.  125 

membranes  of  the  internal  ear  frequently  occur  in  children,  who 
fleep  in  cold  rooms,  or  near  a  cold  wall,  without  a  night-cap. 
If  the  bones  are  affected,  they  come  out  in  a  long  procefs  of  time, 
ni:d  the  child  remains  deaf  of  that  ear.  But  in  this  cafe  there  is 
generally  a  fever  attends  this  inflammation  j  and  it  then  belongs 
r.o  another  genus. 

M.  M.  A  warmer  night-cap.  Warmifh  water  {hould  be 
gently  fyringed  into  the  ear,  to  keep  it  clean,  twice  a  day  ;  and 
if  it  does  not  heal  in  a  week,  a  little  fpirit  of  wine  {hould  be 
added  ;  firft  about  a  fourth  parr,  and  it  {hould  be  gradually  in- 
creafed  to  half  rectified  fpirit  and  half  water  :  if  it  continues 
long  to  difcharge  matter  with  a  very  putrid  fmell,  the  bones  arc 
injured,  and  will  in  time  find  their  exit  ;  during  which  time 
the  ear  fhould  be  kept  clean,  by  filling  it  with  a  weaker  mixture 
of  fpirit  of  wine  and  water,  or  a  folution  of  alurn  in  water  ; 
\vhich  may  be  poured  into  the  ear,  as  the  head  is  inclined,  and 
fhook  out  again  by  turning  the  head,  two  or  three  times  morn- 
ing and  evening.  See  Clafs  II.  1.4.  10. 

9.  Ftftula  lacrymalis.     The  lacrymal  fack,  with  its  punfla  lac- 
rymalia  and  nalal  duel:,  are  liable  to  be  deftroyed  by  fuppuration, 
•without  fever ;  the  tears  then  run  over  the  eyelids,  and  inflame 
the  edges  of  them  and  the  cheeks,  by  their  perpetual  moiilure 
and  faline  acrimony. 

M.  M.  By  a  nice  furgical  operation,  a  new  aperture  is  to  be 
naade  from  the  internal  corner  of  the  eye  into  the  noftril,  and  a 
filver  tube  introduced,  which  fupplies  the  defect  by  admitting 
the  tears  to  pafs  again  into  the  noftril.  See  Melanges  de  Chir- 
urgie,  par  M.  Pouteau ;  who  thinks  he  has  improved  this  oper-* 
ation. 

10.  Fiftula  in  ano.     A  mucous  difcharge  from  the  anus,  call- 
ed by  fame  white  piles,  or  matter  from  a  fuppurated  pile,  lias 
been  miftaken  for  the  matter  from  a  concealed  fiftnla.     A  bit  of 
cotton-wool  applied  to  the  fundament  to  receive  the  matter,  and 
renewed  twice  a  day  for  a  week  or  two,  fhould  always  be   ufed 
before  examination  with  the   probe.     The  probe  of  an  unfkilful 
empyric  fometimes  does  more  harm  in  the  loofe  cellular  mem- 
brane of  thefe  parts  than  the  original  ulcer,  by  making  a  fiitula 
he  did  not  find.     The  cure  of  a  fiitula  in  ano,  of  thofe  who  have 
been  much  addicted  to  drinking-  fpirituous  liquor,   or  who  have 
a  tendency  to  pulmonary  confumption,  is  frequently  of  danger- 
ous confequence,  and  is  fucceeded  by  ulcers  of  the  lungs,  and 
death* 

M.  M.  Ward's  pafte,  or  20  black  pepper-corns  taken  after 
/each  meal  twice  a  day  ;  the  pepper-corns  fliould  be  cut  each  in- 
to two  or  three  pieces.  The  late  Dr.  Munro,  of  Edinburgh, 

VOL.  II.  F  *  aflerted 


*5tf  DISEASES  Clafs  It  i.  4.  if} 

sflerted,  in  his  le&ures,  that  he  had  known  a  fiftula  in  ano  cured 
by  injecting  firft  a  mixture  of  rectified  fpirit  of  wine  and  water  ; 
and,  by  gradually  increafmg  the  ftrength  of  it,  till  the  patient 
could  bear  rectified  fpirit  alone  •,  by  the  daily  ufe  of  which,  at 
length,  the  fides  of  the  fiftula  became  callous,  and  ceafed  to  dif- 
charge,  though  the  cavity  was  left.  A  French  furgeon  has 
lately  affirmed,  that  a  wire  of  lead  put  m  at  the  external  open- 
ing of  the  ulcer,  and  brought  through  the  rectum,  and  twifted 
together,  will  gradually  wear  itfelf  through  the  gut,  and  thus  ef- 
fect a  cure  without  much  pain.  The  ends  of  the  leaden  wire 
irtuft  be  twifted  more  and  more  as  it  becomes  loofe.  Or,  laftly, 
it  muft  be  laid  open  by  the  knife. 

1 1 .  Fiftula  urethra.  Where  a  ftrieture  of  the  urethra  exifts, 
from  whatever  caufe,  the  patient,  in  forcing  the  dream  of  urine 
through  the  ftritture,  diftends  the  urethra  behind  it ;  which, 
after  a  time,  is  liable  to  burft,  and  to  become  perforated  \  and 
fome  of  the  urine  is  pufhed  into  the  cellular  membrane,  occa- 
fioning  fiftulas,  which  fometimes  have  large  furfaces  producing 
much  matter,  which  is  prefied  out  at  the  time  of  making  water, 
•and  has  been  miftaken  for  a  catarrh  of  the  bladder  ;  thefe  fiftu- 
las fometimes  acquire  an  external  opening  in  the  perinaeum,  and 
part  of  the  urine  is  difcharged  that  way. 

Can  this  matter  be  diftinguifhed  from  mucus  of  the  bladder  by 
the  criterion  delivered  in  Clafs  II.  i.  6.  6.  ? 

M.  M.  The  perpetual  ufe  of  bougies,  either  of  catgut  or  of 
caoutchouc.  The  latter  may  be  had  at  No.  37,  Red-lion-ftreet, 
Holborn,  London.  The  former  are  eafily  made,  by  moiftening 
the  catgut,  and  keeping  it  ftretched  till  dry,  and  then  rounding 
one  end  with  a  pen-knife.  The  ufe  of  a  warm  bath  every  day 
for  near  an  hour,  at  the  heat  of  94  or  96  degrees,  for  two  or 
three  months,  I  knew  to  be  uncommonly  luccefsful  in  one  cafe  ;• 
the  extenfive  fiftulas  completely  healing.  The  patient  fhould 
introduce  a  bougie  always  before  he  makes  water,  and  endeavour 
to  make  it  as  flowly  as  poflible.  See  Clafs  I.  2.  3.  24* 

1 2.  Hepatitis  chronica.  Chronical  inflammation  of  tHs  liver. 
A  collection  of  matter  in  the  liver  has  frequently  been  found  on 
diflecftion,  which  was  not  fufpecled  in  the  living  fubjecl:.  Though 
there  may  have  been  no  certain  figns  of  fuch  a  collection  of 
matter,  owing  to  the  infeniibility  of  the  internal  parts  of  this 
vifcus  ;  which  has  thus  neither  been  attended  with  pain,  nor  in- 
duced any  fever  ;  yet  there  may  be  in  fome  cafes  reafon  to  fuf- 
pecl  the  exiftence  of  fuch  an  abfcefs  ;  either  from  a  fenfe  of  ful- 
iiefs  in  the  right  hypochondre,  or  from  tranfient  pains  fometimes 
felt  there,  or  from  pain  on  preiTure,'or  from  lying  on  the  left  fide, 
and  iometimes  from  a  degree  of  fenfitive  fever  attending  it. 

Dr.  Baunders- 


CLASS  II.  i.  4.  13.      OF  SENSATION. 

Dr.  Saundcrs  fufpefts  the  acute  hepatitis  to  exift  in  the  in- 
flammation of  the  hepatic  artery,  and  the  chronical  one  in  that 
of  the  vena  poriarum.  Treatife  on  the  Liver.  Robinlbns. 
London. 

13.  Scrofula  fuppiirans.     Suppurating  fcrofula.     The  indolent 
tumors  of  the  lymphatic   glands  are  liable,  after  a  long  time,  to 
regain  their  ienfibility  ;  and  then,  owing  to  their  former  torpor, 
an  increafed  aclion  of  the  vefTels,  beyond  what  is  natural,  with 
inflammation,  is  the  conference  of  their  new  life,  and  fupnura- 
tion  fucceeds.     This  cure  of  fcrofula  generally  happens  about 
puberty,  when  a  new  energy  pervades  the  whole  fyftem,  and  un- 
folds the  glands  and  organs  of  reproduction. 

M.  M.  SeeClafsI.  2.  3.  21.  Where  fcrofulous  ulcers  about 
the  neck  are  difficult  to  heal,  Dr.  Beddoes  was  informed,  in  Ire- 
land, that  an  empyric  had  had  lome  fuccefs  by  inflaming  them  by 
an  application  of  wood  forrel,  oxalis  aceto  fella,  the  leaves  of  which 
are  bruifed  in  a  mortar,  and  applied  on  the  ulcers  for  two  or 
three  days,  and  then  fome  more  lenient  application  is  ufed. 

A  poor  boy,  about  twelve  years  old,  had  a  large  fcrofulous  ul- 
cer on  one  fide  of  the  cheft  beneath  the  clavicle,  and  another 
under  his  jaw  ;  he  was  directed,  about  three  weeks  ago,  to  pro- 
cure a  pound  of  dry  oak-bark  from  the  tanners,  and  to  reduce  it 
to  fine  powder,  and  to  add  to  it  one  ounce  of  white  lead  in  fine 
powder,  and  to  cover  the  ulcers  daily  with  it,  keeping  it  on  by 
brown  paper  and  a  bandage.  He  came  to  me  a  few  minutes 
ago,  to  fhew  me  that  both  the  ulcers  are  quite  healed.  The  con- 
ftant  application  of  linen  rags,  moiftened  with  a  folution  of  an 
ounce  of  fugar  of  lead  in  a  pint  of  water,  I  think  I  have  feen. 
equally  efficacious. 

Small  dofes  internally  of  a  folution  of  arfenic  have  been  faid 
to  contribute  to  cure  thefe  ulcers.  I  fhould  recommend  from, 
one  drop  to  five  of  a  faturated  decoction  of  arfenic,  as  directed 
in  Mat.  Med.  Art.  IV.  2.  6.  8.  for  children,  twice  or  thrice  a 
day,  according  to  their  age,  and  from  five  to  ten  to  grown  per- 
fons,  diminifhing  the  quantity  if  it  affects  the  bowels.  Tinc- 
ture of  Digitalis  is  recommended  in  Clafs  I.  2.  3.  21. 

14.  Scorbutuf  fuppurans*     In  the  fea-fcurvy  there  exifts  an 
inactivity  of  venous  abforption,  whence  vibices  and  petechise,, 
and  fometimes  ulcers.     As  the  column  of  blood  prefling  on  the 
origins  of  the  veins  of  the  lower  extremities,  when  the  body  is 
creel,  oppofes  the  afcent  of  the  blood  in  them,  they  are  more 
frequently  liable  to  become  enlarged,  and  to  produce  varixes,  or 
vibices,  or,  laftly,  ulcers  about  the  legs,  than  on  the  upper  parts 
of  the  body.     The  expofure   to  cold  is  believed   to  be  another 

of  ulcers  on  the  extremities  j  as  happens  to  many  of  the 

poor 


DISEASES  GLASS  II.  r.  4.  15. 

poor  in  winter,  at  Lifbon,  who  fleep  in  the  open  sir,  without 
blockings,  on  the  fteps  of  their  churches  or  palaces.     See  Clafs  I. 

2.  I.    15. 

M.  M.  A  bandage  fpread  with  plafter  to  cover  the  whole 
limb  tight.  Rags  dipped  in  a  folution  of  fugar  of  lead.  A 
warm  flannel  itccking  or  roller.  White  lead  and  oak-bark? 
both  in  fine  powder.  Horizontal  reft.  An  ingenious  treatife 
on  the  ufe  of  bandage,  in  the  cure  of  ulcers,  has  lately  been  pub- 
limed  by  Mr.  Baynton,  of  Briftol ;  and  another,  on  the  fame  fub- 
je6t,  by  Mr.  Whately,  of  London,  who  fucceeds  without  ufmg 
•plafter  on  the  bandage. 

15.  Scirrhus  fuppuruns.     When  a  fcirrhus  affects  any  gland 
of  no  great  extent  or  fenfibility,  it  is,  after  a  long  period  of  time, 
liable  to  fuppurate  without  inducing  fever,  like  the  indolent  tu- 
mors of  the  conglobate  or  lymphatic  glands  above  mentioned  ; 
whence  collections  of  matter  are  often  found  after  death,  both  in 
men  and  other  animals  j  as  in  the  livers  of  fwine,  which  have 
been  fed  with  the  grounds  of  fermented  mixtures  in  the  diftil- 
leries.     Another  termination  of  fcirrhus  is  in  cancer,  as  defcri- 
bed  below.     See  Clafs  I.  -2.  3.  22. 

1 6.  Carcinoma.     Cancer.     When  a  fcirrhous  tumor  regains 
its  fenfibility  by  nature,  or  by  any  accidental  hurt,  new  veffels 
{hoot  amongft  the  yet  infentible  parts  of  it,  and  a  new  fecretiorj 
takes  place  of  a  very  injurious  material.     This  cancerous  mat- 
ter is  abforbed,  and  induces  fwelling  of  the  neighbouring  lymph- 
atic glands  j    which  aUp    become  fcirrhous,    and  afterwards 
cancerous. 

This  cancerous  matter  does  not  feem  to  acquire  its  malignant 
or  contagious  quality,  till  the  cancer  becomes  an  open  ulcer  ; 
and  the  matter  fecreted  in  it  is  thus  expofed  to  the  air.  Then 
it  evidently  becomes  contagious,  becaufe  it  not  only  produces 
hectic  fever,  like  common  matter  in  ulcers  open  to  the  air,  but 
it  alfo,  as  it  becomes  abforbed,  fwells  the  lymphatic  glands  in  its 
vicinity ;  as  thofe  of  the  axil] a,  when  the  open  cancer  is  on  the 
breaft.  See  Clafs  II.  i.  3. 

Hence  exfeclion  before  the  cancer  is  open  is  generally  a  cure ; 
but  after  the  matter  has  been  expofed  to  the  air,  it  is  feldom 
of  fervice  ;  as  the  neighbouring  lymphatic  glands  are  already  in- 
fe£ted.  I  have  obferved  feme  of  thde  patients  after  the  opera- 
tion to  have  had  difeafed  livers,  which  might  either  have  previ- 
oufly  exifted,  or  have  been  produced  by  the  fear  or  anxiety  at- 
tending the  operation. 

Erofion  with  arfenic,  after  the  cancer  is  become  an  open  ul- 
cer, has  generally  no  better  effeft  than  exfeclion,  but  has  been 
fuccefjjful  before  ulceratioa.  The  bcft  manner  of  ufmg  arfenic, 


€LASS  H.  i.  4.  16.       OF  SENSATION. 

is  by  mixing  one  grain  with  a  drachm  of  lapis  calminaris,  and 
(brewing  on  the  cancer  iorne  of  the  powder  every  day,  till  the 
whole  is  deftroyed. 

Cancers  on  the  face  are  faid  to  arife  from  the  periofteum,  and 
that,  unleis  this  be  deftroyed  by  the  knife,  or  by  cauftics,  the 
cancer  certainly  recurs.  After  the  cancer  becomes  an  open 
ulcer  of  fome  extent,  a  purulent  fever  fupervenes,  as  from  other 
open  ulcers,  and  gradually  dedroys  the  patient.  See  Clafs  II.  i. 
6.  13. 

Two  very  intereding  cafes  have  been  lately  publifhed  by  Dr. 
Ewart,  of  Bath,  in  which  carbonic  acid  gas,  or  fixed  air,  was  • 
kept  conftantly  in  contact  with  the  open  cancerous  ulcers  of  the 
bread  ;  which  then  healed  like  other  common  ulcers.  This 
is  rather  to  bealcribed  to  the  exclufion  of  oxygen,  than  to  any 
Specific  virtue  in  the  carbonic  acid.  As' in  common  ulcers  the 
matter  does  not  induce  hectic  fever,  till  it  has  been  expofed 
£o  the  air,  and  then  probably  united  with  oxygen. 

The  manner  of  applying  the  fixed  air,  is  by  including  the  can- 
cer in  one  half,  or  hemifphere,  of  a  large  bladder  ;  the  edges  are 
made  to  adhere  to  the  (kin  by  adhefive  plafler,  or  perhaps  a  mix- 
ture of  one  part  of  honey  with  about  twenty  parts  of  carpenter's 
glue  might  better  fuit  fome  tender  {kins.  The  bladder  is  then 
kept  conftantly  filled  with  carbonic  acid  gas,  by  means  of  a  pipe 
in  the  neck  of  it  ;  and  the  matter  let  out  at  a  fmall  aperture  be- 
neath. 

M.  M.  Where  extirpation  is  not  advifable,  as  in  mod  open 
cancers  of  the  bread,  keep  the  ulcer  carefully  from  the  air,  either 
by  applying  carbonic  acid  gas,  as  above  ;  or  by  covefing  it  with 
(charcoal  in  powder,  and  a  double  oiled  (ilk.  The  charcoal-pow- 
der mould  be  renewed  once  in  two  or  three  days,  and  at  thofe 
times  itihould  be  pufhed  ofFby  frefh  charcoal-powder  on  lint,  fo  as 
not  for  a  moment  to  expofe  it  to  the  air.  The  charcoal  mould 
be  frefh  taken  from  the  fire,  and  powdered  very  fine  as  foon  as 
cool,  and  kept  in  a  bottle  to  be  as  little  expofed  to  the  air  as  pof- 
£ble. 

The  tumor  fhould  be  fufpended  by  a  fafh  or  foft  cufhion,  f* 
as  to  keep  it  as  eafy  as  poflible  night  and  day,  and  mould  be  kept 
jieither  too  warm  nor  too  cold,  as  both  extremes  are  injurious. 

Internally,  fix  grains  of  rhubarb  every  night,  for  many  months, 
and  to  drink  nothing  ftronger  than  common  weak  fmall  beer, 
confiding  of  three  drike  of  malt  to  the  hogfhead,  or  wine  diluted 
with  thrice  its  quantity  of  water. 

If  cauftics  cannot  be  applied  fo  as  to  deftroy  the  whole,  even 
before  ulceration,  I  fufpect  that  they  aggravate  the  evil,  and 
Jooner  deftroy  the  patient  j  as,  I  was  well  informed,  occurred 

to 


23°  DISEASES  CLASS  II.  i.  4.  17. 

to  a  quack  who  was  for  a  time  much  refortcd  to,  in  this  part  of 
the  country. 

Another  method  of  ufmg  charcoal-powder  is  by  mixing  it  with 
boiled  oil,  to  the  confidence  of  common  paint ;  and  to  foak  a 
piece  of  flannel  with  this,  and  cover  the  ulcer  j  and  daily  to 
ihove  or  thruft  this  off  by  applying  the  edgt  of  another  piece  of 
flannel,  foaked  with  the  oil  and  charcoal,  to  the  edge  of  that  up- 
on the  ulcer,  fo  as  to  change  them  without  the  poffibility  of  let- 
ting any  air  come  into  contact  with  the  cancerous  fore. 

1 7.  Arthrocele.  Swelling  of  the  joints  feems  to  have  its  remote 
caufe  in  the  foftnefs  of  the  bones,  for  they  could  not  fwell  unlefs 
they  were  previoufly  foftened,  fee  Clafs  1.  2.  2-  1 2.  The  epiphy-^ 
fes,or  ends  of  the  bones,  being  naturally  of  a  loofer  texture,  are 
moil  liable  to  this  difeafe,  and  perhaps  the  cartilages  and  capfu* 
lar  ligaments  may  alfo  become  inflamed  and  fwelled  along  with 
the  heads  of  the  bones.  This  malady  is  liable  to  diftort  the  fin- 
gcrs  and  knees,  and  is  ufu-ally  called  gout  or  rheumatifm  ;  the 
former  of  which  is  liable  to  dilable  the  fingers  by  chalk-ftones, 
and  thence  to  have  fomewhat  a  fimilar  appearance.  But  the 
arthrocele,  or  fwelling  of  the  joints,  affects  people  who  have  not 
been  intemperate  in  the  ufe  of  fermented  or  fpirituous  liquors  ; 
or  who  have  not  previoufly  had  a  regular  gout  in  their  feet ;  and 
in  both  thefe  circumftances  differs  from  the  gout.  Nor  does 
it  accord  with  the  inflammatory  rheumatifm,  as  it  is  not  attended 
with  fever,  and  becaufe  the  tumors  of*  the  joints  never  entirely 
fubfide.  The  pain  or  fenfibility,  which  the  bones  acquire  when 
they  are  inflamed,  may  be  owing  to  the  new  veffels,  which  (hoot 
in  them  in  their  foft  ftate,  as  well  as  to  the  diltention  of  the; 
old  ones. 

M.  M.  Half  a  grain  of  opium  twice  a  day,  gradually  increafed 
to  a  grain,  but  not  further,  for  many  months.  Thirty  grains  of 
powder  of  bark  twice  a  day  for  many  months.  Ten  grains  of 
bone-ames,  or  calcined  hartfhorn,  twice  a  day,  with  decoction 
of  madder  ?  Soda  phofphorata  ? 

1 8.  Arthropuofis.  Joint-evil.  This  differs  from  the  former, 
as  that  never  fuppurates;  thefe  ulcers  of  the  joints  are  gener- 
ally efteemed  to  arife  from  fcrofula  ;  but  as  fcrofula  is  a  difeafe 
of  the  lymphatic  or  abforbent  fyftem,  and  this  confifts  in  the 
fuppuration  of  the  membranes,  or  glands,  or  cartilages  about 
the  joints,  there  does  not  feem  a  fufficient  analogy  to  authorize 
their  arrangement  under  the  fame  name. 

The  white  fwelling  of  the  knee,  when  it  fuppurates,  comes  un- 
der this  fpecies,  with  variety  of  other  ulcers,  attended  with  cari- 
ous bones. 

19.  Caries  ojjlum^  or  Necro/is  ojfium.     A  caries  of  the  bones 

may 


it.  i.  4.  i$;      OF  SENSATION; 

may  be  termed  a  fuppuration  of  them  ;  it  differs  from  the  above, 
as  it  generally  is  occafioned  by  fome  external  injury,  as  in  decay- 
ing teeth ;  or  by  veneral  virus,  as  in  nodes  on  the  tibia  ;  or  by 
other  matter  derived  to  the  bone  in  malignant  fevers  ;  and  is  not 
confined  to  the  ends  of  them. 

The  feparation  of  the  dea'd  bone  from  the  living  is  a  work  of 
fome  time.  See  Sect.  XXXIII.  3.1.  A  new  and  able  work  on 
the  necrofis  of  bones  is  publifhed  by  I.  Ruflel,  Edinburgh'  5 
London,  Robinfons.  And  another  by  I.  P.  Weidmann,  de  Ne- 
crofi  Oflium  at  Francfort ;  Boofey,  London  ;  which  is  alfo  a 
val  uable  work. 

M.  M.  When  this  difeafe  is  not  formed  in  fyphilis,  or  by 
metaftaiis  in  fever,  but  is  {imply  an  inflammation  of  the  periofte- 
um,  or  of  the  folid  bone,  or  of  its  medullary  cells,  the  method  of 
cure  mould  confift  in  evacuations  by  bleeding  and  cathartics, 
and  by  leeches  applied  to  tlie  painful  or  tumid  parts  ;  and  after- 
wards by  taking  inwardly  foda  phofphorata  and  a  decoction  of 
rubia  tinftorum,  madder-root  ;  as  the  former  is  believed  to  give 
folidity  to  bones,  and  the  latter,  as  it  colours  the  bones  of  young 
or  growing  animals,  is  known  to  be  carried  thither  during  their 
fofter  or  more  fenfitive  ftate,  and  may  be  therefore  worth:  a  triaL 
See  Innutritio  oflium.  Clafs  I.  2.  2.  14. 


QRDO 


£32  DISEASES  CLASS  it  i.  4.  if 

>  ORDO    I. 

Increafed  Senfation. 

GENUS  V. 

With   the  Production  of  new   Vejjjels  by  external  Membranes   or 
G  lands  >  Without  Fever. 

THE  ulcers,  or  eruptions,  which  are  formed  on  the  external 
fkin,  or  on  the  mouth  or  throat,  or  on  the  air-cells  of  the  lungs, 
or  on  the  inteftines,  all  of  which  are  more  or  lefs  expo  fed  to  the 
contact  of  the  atmofpheric  air,  which  we  breathe,  and  which  in 
feme  proportion  we  fwallow  with  ow  food  and  faliva  5  or  to 
the  contact  of  the  inflammable  air,  or  hydrogen,  which  is  fet  at 
liberty  by  the  putrefying  aliment  in  the  intellines,  or  by  putre- 
fying matter  in  large  abfcefies  *  all  of  them  produce  contagious 
matter  ;  which,  on  being  inoculated  into  the  fein  of  another 
perfon,  will  produce  fever,  or  a  fimilar  difeafe. 

Irt  fome  cafes  even  the  matter  formed  beneath  the  fkin  be- 
comes in  fome  degree  contagious,  at  lead  fo  much  fo  as  to  pro- 
duce fever  of  the  hectic  or  malignant  kind,  as  foon  as  it  has  pierc- 
ed through  the  (kin,  and  has  thus  gained  accefs  to  fome  kind  of 
air  ;  as  the  frefh  pus  of  a  common  abfcefs  ;  or  the  putrid  pus 
of  an  abfcefs  which  has  been  long  confined  ;  or  of  cancerous 
ulcers. 

From  this  analogy  there  is  reafon  to  fufpect  that  the  matter  of 
all  contagious  difeafes,  whether  with  or  without  fever,  is  not  in-* 
fedtious  till  it  has  acquired  fomething  from  the  air  ;  which,  by 
oxygenating  the  fecreted  matter,  may  probably  produce  a  new 
acid.  And,  fecondly,  that  in  hectic  fever  a  part  of  the  purulent 
matter  is  abforbed  ;  or  acts  on  the  furface  of  the  ulcer  ;  as  va- 
riolous  matter  affects  the  inoculated  part  of  the  arm.  And  that 
hectic  fever  is  therefore  caufed  by  the  matter  of  an  open  ulcer  ; 
and  not  by  the  fenfation  in  the  ulcer  independent  of  the  aerated 
pus,  which  lies  on  it  Which  may  account  for  the  venereal  mat- 
ter from  buboes  not  giving  the  infection,  according  to  the  exper- 
iments of  the  late  Mr.  Hunter,  and  for  fome  other  phenomena 
«f  contagion.  See  Variola  difcreta,  Clafs  II.  I.  3.9. 

SPECIES. 

I.  Gonorrhoea  venerea.  A  pus-like  contagious  material  dif- 
charged  from  the  urethra  after  impure  cohabitation,  with  fmart- 


CLASS  II.  i.  5.  i.  OF  SENSATION.  233 

ing  or  heat  on  making  water  ;  which  begins  at  the  external  ex- 
tremity of  the  urethra,  to  which  the  contagious  matter  is  appli- 
ed, and  where  it  has  accefs  to  the  air  •,  which  probably  height- 
ens its  acrimony. 

M.  M.  In  this  (late  of  the  venereal  difeafe,  once  venefecfHon, 
with  mild  cathartics  of  fenna  and  manna,  with  mucilage,  as  al- 
jnond  emulfion,  and  gum  arable,  taken  for  two  or  three  weeks, 
abfolve  the  cure.  Is  camphor  of  ufe  to  relieve  the  ardor  urinre  ? 
Do  balfams  increafe  or  leiTen  the  heat  of  urine  ?  Neutral  falts 
certainly  increafe  the  fmarting  in  making  water,  by  increafmg 
the  acrimony  of  the  urine. 

Can  the  difcharge  from  the  urethra  be  foon  flopped  by  faturnine  ' 
injections,  or  mercurial  ones,  or  with  folution  of  blue  vitriol,  at 
firft  very  dilute,  and  gradually  made  ftronger  ?  And  at  the  fame 
time,  left  the  fyphilis,  or  general  difeafe,  mould  fupervene,  the 
patient  might  take  a  quarter  of  a  grain  of  corrofive  fublimare  of 
mercury  twice  a  day,  as  directed  below  ? 

There  is  a  curious  paper  by  Mr.  Addington,  of  Weft  Bromage, 
In  the  Contributions  of  Medical  Knowledge,  publifhed  by  Dr. 
Beddoes,  on  the  cure  of  gonorrhoea  virulenta,  by  large  dofes  of 
corrofive  fublimate  of  mercury,  hydrargyrus  muriatus.  Three 
grains  of  corrofive  fublimate  of  mercury  are  diffolved  in  one  ounce 
of  rectified  fpirit  of  wine.  Half  of  this  mixture  is  taken  undi- 
luted at  going  to  bed  ;  it  produces  a  copious  falivation  for  an 
hour  and  a  half,  or  longer,  during  which  the  patient  fpits  a 
quart.  Some  Glauber's  falts  are  to  be  taken  on  the  fecond  day 
after  this  operation,  and  on  the  evening  of  that  day  he  is  to  re- 
peat the  draught,  and  the  falts  on  the  day  but  one  following. 
And  Mr.  Addington  witneffed  that  three  or  four  fuch  dofes  fre- 
quently cured  a  venereal  gonorrhoea  in  fo  ihort  a  time,  without 
any  difagreeable  confequence,  and  was  informed  that  hundreds 
had  been  cured  by  it. 

The  probable  mode  of  action  of  this  medicine  is  owing  to  the 
confent  of  parts  between  the  throat  and  the  urethra,  of  which 
many  inftances  are  given  in  Clafs  IV.  i.  2.  7.  on  Hydrophobia. 
Mr.  Wright,  an  elderly  furgeon  in  Derby,  thirty  years  ago,  af- 
fured  me  that  he  had  frequently  given  half  a  drachm  of  corrofive 
Sublimate  as  an  emetic,  without  any  inconvenience  to  the  patient ; 
and  that  it  was  the  famous  emetic  of  a  celebrated  empyric,  and 
had  been  faid  to  do  wonders. 

Might  not  this  dofe  of  one  grain  and  a  half,  diffolved  in  half 
an  ounce  of  rectified  fpirit,  be  given  repeatedly,  with  profpett 
of  advantage,  in  Hydrophobia1  ?  And  perhaps,  in  an  adapted 
flrength  and  quantity,  in  Hydrocephalus  ?  If  in  Croup,  Perip- 
aeumonia  trachealis  ? 

VOL.  II.  G  G  2.   Syphilis. 


234  DISEASES  CLASS  II.  i.  5. 2. 

2.  Syphilis.  Venereal  difeafe.  The  contagion  (hews  itfelf 
in  ulcers  on  the  part  firil  inoculated,  as  chancres  ;  ulcers  on  the 
tonfils  fucceed,  with  eruption  on  the  {kin,  efpecially  about  the 
roots  of  the  hair  ;  afterwards  on  other  parts  of  the  {kin,  termin^ 
iating  in  dry  fcabs  ;  and,  laltly,  with  pain  and  fwelling  of  the 
bones. 

:  The  corona  veneris,  or  crown  of  Venus,  confifts  of  the  erup- 
tions at  the  roots  of  the  hair  appearing  molt  round  the  forehead  $ 
which  is  occaftoned  by  this  part  being  more  expofed  to  the  air  ; 
which  we  obferved,  at  the  beginning  of  this  genus,  either  produ- 
ces or  increales  the  virulence  of  contagious  matter.  But  it  is 
difficult  to  conceive,  from  this  hiftory,  why  the  throat  fhould  be 
firft  afte&ed  ;  as  it  cannot  be  iuppofed,  that  the  difeafe  is  fa 
often  taken  by  the  faliva,  like  the  fmail-pox,  though  this  may 
fometimes  occur ;  perhaps  very  often.  The  connection  be- 
tween the  genitals  in  men  and  the  throat,  is  treated  of  in  Clafs 
IV.  i.  2,  7.  Hydrophobia. 

M.  M.  A  quarter  of  a  grain  of  corrofive  fublimate  of  mer- 
cury, taken  thrice  a  day  for  five  or  fix  weeks,  made  into  a  pill 
with  bread-crumbs,  or  diflblved  in  a  fpoonful  of  brandy  and 
water,  is  a  Very  efficacious  and  almoft  certain  cure.  When  it 
does  not  fucceed,  it  is  owing  either  to  the  drug  being  had, 
or  to  its  having  precipitated  from  the  brandy,  or  from  its  being 
fpoiled  in  the  pill  by  long  keeping.  Opium  contributes  much 
to  expedite  the  cure,  both  of  the  fimple  gonorrhoea  and  of  ve- 
nereal ulcers,  by  increafing  abforption  both  from  the  mucous 
membrane  and  from  the  furface  of  ulcers.  A  quarter  of  a  grain, 
or  half  a  grain,  may  l>e  given  with  every  dofe  of  the  fublimate. 

Nitrous  acid  has  been  lately  ftrongly  recommended,  by  Mr. 
Scott,  in  venereal  cafes  ;  from  an  idea  that  the  oxygen,  which 
it  confiils  of  m  part,  is  loofely  combined,  and  may  be  feparable  in 
the  animal  fyftem  ;  and  that  it  may  be  the  oxygen,  only,  which 
exifls  Icofely  in  mercurial  calces  or  oxydes,  that  acls  fo  fuccefs- 
fully,  when'mercurials  are  exhibited.  Some  fuccefsful  exhibi- 
tions of  this  acid  in  venereal  cafes  are  publifhed  ;  the  dofe  is  one 
drachm  and  a  half,  or  two  drachms,  of  the  ftrong  nitric  acid 
mixed  in  two  pounds  of  water,  to  be  drunk  daily  at  repeated  in- 
tervals. Mr.  Scott  has  fince  ufed  the  nitrous  acid  much  diluted 
with  water  externally  as  a  warm  bath,  either  partially  or  gener- 
ally, with  great  fuccefs,  at  Bombay,  in  venereal  cafes.  See  Ar-? 
tide  II.  2.  4.  and  IV.  2.  7.  i.  in  the  Materia  Medica. 

It  has  been  now  ufed  in  this  country  with  fuccefs  by  fome, 
and  without  fuccefs  by  others,  and  may  perhaps  aflift  the  ufe  of 
mercurials  as  well  as  opium  in  the  cure  of  veneral  ulcers  ;  but 
fhould  not  yet  be  folcly  depended  upcn. 

3. 


& A?S  II.  i.  5.  3.        OF  SENSATION. 

3.  Lepra.      Leprofy.      Leprofy  of  the  Greeks.     The  (kin  is 
rough  with  white  branny  fcales,  which  are  full  of  chinks  ;  often 
moiil  beneath,  and  itching.     Th.e  fcales  on  the  head  or  arms  of 
fome  drinking  people  are  a  difeafe  of  this  kind.     The  perfpirnble 
matter  defigned  for  the  purpofe  of  lubricating  the  external  ikin  is 
fecreted  in  this  difeafe  in  a  too  vifcid  (late,  owing  to  the  inflam- 
mation  of  the  fubcutaneous  veflels  ;  and,  as  the  abforbents  act 
too  ftrongly  at  the  fame  time,  a  vifcid  mucus  is  left  adhering  to 
the  furface  of  the  fkin. 

In  the  leprofy  of  the  Jews,  defcribed  in  the  thirteenth  and  four- 
teenth chapters  of  Leviticus,  the  depreflion  of  the  fore  beneath 
the  furface  of  the  fkin,  and  the  hairs  in  it  becoming  \vhite,  • 
to  have  been  the  principal  circumftances,  which  the  prielt  wa* 
directed  to  attend  to  for  the  purpofe  of  afcertaining  the  dif- 
eafe. 

M.  M.  EfTenc*:  of  antimony,  from  20  drops  to  100,  twice  or 
thrice  a  day,  with  half  a  pint  of  decoction  of  elm-bark  ;  or  of 
malt-tea  ;  or  tincture  of  .cantharides,  from  20  to  60  drops,  four 
times  a  day  ;  or  fublimate  of  mercury,  with  much  diluting 
fluid.  Acid  of  vitriol  ?  Perhaps  the  cure  chiefly  depends  on 
much  dilution  with  water,  from  two  to  four  pints  a  day,  in 
which  elm-bark,  or  pine-buds,  or  juniper-tops,  may  be  boiled. 
Bath  or  Buxton  water  drunk  in  large  quantities.  Warm  bath. 
Oil-lkin  bound  on  the  part  to  confine  the  perfpirable  matter. 
Ointment  of  tar  and  fuet ;  or  poultice  for  two  or  three  days,  and 
then  cerate  with  lapis  calaminaris.  Diet  of  raiiins  and  bread. 
Abflinence  from  wine^  beer,  and  all  fpirits,  is  indifpehfably  nec- 
eflary  to  the  cure. 

4.  Elephantiqfis;     Leprofy  of  the  Arabs.     A   contagious  dif- 
eafe ;  the  fkin  is  thickened,   wrinkled,  rough,  unftuous,  defti- 
tute  of  hair,-  without  any  fenfation  of  touch   in  the  extremities 
of  the  limbs  ;  the  face  deformed  with  tubercles  ;  the  voice  hoarfe, 
and  with  a  nafal  tone.     Cullen. 

5.  Framboejia.     Yaws  is  faid  to  be  contagious  and  hereditary, 
It  principally  affects  the  negroes  in  the  Weft  Indies.      Edinb. 
Eflays,Vol,VI. 

6.  Pfera,     Itch.      A  contagious  prurient   eruption.     There 
are  two  kinds  of  itch  :  that  which  appears  between  the  finders 
and  under  the  joints  of  the  knees  and  elbows  ;  and  that  \\ 
feldom  is  feen  in  thefe  places,  but  all  over  the  other  parts  of  the 
body.     The  latter  is  feldom  thought  to  be  the  itch,  as  it  does 
noteafily  infect  even  a  bed-feljow,  and  refills  the  ufual  mea 
cure  by  brimftone. 

If  the  itch  be  cured  too  haftily,  by  rubbing  mercurial  or  ar- 
fenical  preparations  over  the  whole  body,  or  on  too  great  a  pare 


DISEASES          ciafe  n.  i.  5. 6, 

of  it,  many  bad  fymptoms  are  produced ;  as  weaknefo  of  digef- 
tion,  with  pale  bloated  countenance,  and  tendency  to  dropfy. 
I  have  twice  feen  St.  Vitus's  dance  occur,  from  the  ufe  of  a  mer- 
curial girdle  ,  and  once  a  fwelled  liver.  I  have  alfo  feen  a  fwell- 
ed  fpleen  and  fwelled  legs  from  the  external  ufe  of  arfenic  in  the 
cure  of  the  itch.  And  very  numerous  and  large  phlegmons 
commonly  fucceed  the  too  hafty  cure  of  it  by  other  means. 

There  does  not  appear  a  ftri£l  analogy  between  the  hafty  cure 
of  the  itch,  and  the  retroceffion  of  the  puftules  in  the  feeondary 
fever  of  the  fmall-pox  ;  becaufe  in  that  the  abforption  of  the 
matter  is  evinced  by  the  fwelling  of  the  face  and  hands,  as> 
the  puftules  recede,  as  explained  in  Clafs  II.  i.  3.  9.  Variola 
difcreta.  And  a  fever  is  produced  by  this  abforption ;  neither 
of  which  happen,  when  the  puftules  of  the  itch  are  deftroyed  by 
mercury  or  arfenic. 

Nor  can  thefe  inconveniences,  which  occur  on  the  too  hafty 
cure  of  the  itch,  be  explained  by  thofe  which  follow  the  cure  of 
fome  kinds  of  gutta  rofea,  Clafs  II.  i.  4.  6.  as  in  thofe  the  erup- 
tions on  the  face  were  an  aflociated  difeafe  with  inflammation,- 
of  the. liver  or  ftomach,  which  they  were  accuftomed  to*  relieve  ; 
whereas  the  itch  is  not  known  to  have  had  any  previous  catena- 
tion with  other  difeafes. 

In  the  itch  there  exifts  not  only  great  irritation  in  the  produc- 
tion of  the  puftules,  but  great  fenfation  is  caufed  by  their  acri- 
mony afterwards  ;  infomuch  that  the  pain  of  itching  without  the 
interrupted  fmarting  occafioned  by  fcratching,  would  be  intol- 
erable. This  great  excitement  of  the  two  fenforial  powers  o£ 
irritation  and  fenfation  is  fo  great,  when  the  puftules  are  diffufed 
over  the  whole  furface  of  the  body,  that  a  torpor  fucceeds  the 
fudden  ceafmg  of  it ;  which  affects  thofe  parts  of  the  fyftem 
which  were  moft  catenated  with  the  new  motions  of  the  fkin, 
as  the  ftomach,  whence  indigeft'on  and  flatulency  ;  or  which 
are  generally  moft  liable  to  fail  into  torpor,  as-  the  numerous 
ids,  which  form  the-  liver.  Whence  the  difeafes  confequent 
to  the  hafty  cure  of  the  itch  are  difeafes  of  debility,  as  tumid  vif- 
cera,  csdematous  fwellings,  and  St.  Vitus's  dance,  which  is  a 
debility  of  afibciation.  In  the  fame  manner  indigeftion,  with 
green  evacuations,  are  faid  to  follow  an  injudicious  application 
of  ceruffa  to  (top  too  haftily  the  exfudation  behind  the  ears  of 
children,  Clafs  I.  i.  2.  9.  And  dropfies  are  liable  to  fucceed 
the  cure  of  old  ulcers  of  the  legs,  which  have  long  ftimulated 
the  fyftem.. 

M.  M.  The  fize  of  a  large  pea,  of  an  ointment  confiding  of 

cne  part  cf  white  precipitate  of  mercury,  to  fix  parts  of  hog's 

•-.veil  triturated  together,  to  be  rubbed  on  a  part  of  the  body 

every 


CLASS  II.  i.  J.  7.        OF  SENSATION.  237 

every  night,  and  wafhed  off  with  foap  and  water  next  morning, 
till  every  part  is  cleared  •,  with  lac  fulphuris  twenty  grains  to  be 
taken  every  morning  inwardly,  Warm  faline  bath,  with  white 
vitriol  in  it.  Flowers  of  fulphur  mixed  with  thick  gruel,  or  with 
hog's  fat.  With  either  of  which  the  body  may  be  fmeared  all 
over. 

Mr.  Grille  fays,  that  thofe  who  get  manganefe  from  its  mines 
are  not  fubjeft  to  the  itch  ;  and  that  he  found  an  ointment,  com- 
pofed  of  fix  parts  of  finely  levigated  manganefe  and  of  fixteen 
parts  of  lard,  a  more  efficacious  remedy  for  the  itch  than  thole  in 
common  ufe.  Parmentier. 

7.  Pfora  ebriorum.     Elderly  people,  who  have  been  much  ad- 
dicted to  fpirituous  drinks,  as  beer,  wine,  or  alcohol,  are  liable 
to  an  eruption  all  over  their  bodies ;  which  is  attended    with 
very   afflicting    itching,  and  which  they  probably   propagate 
from  one  part  of  their  bodies  to  another  with  their  own  nails  by 
fcratching  themfelves.     I  faw  fatal  effects  m  one  fuch    patient* 
by  a  too  extenfive  ufe  of  a  folntion  of  lead  ;  the  eruption   dif  ap- 
peared, he  became  dropfical,  and  died  ;  I  fuppofe  from  the  too 
ifuddenly'  ceafmg  of  the  great  ftimulus  caufed  by  the  eruptions 
Over  the  whole  fkin,  as  in  the  preceding  article. 

M.  M.  The  patient  mould  gradually  accuftom  himfelf  to  half 
his  ufual  quantity  of  vinous  potation.  The  warm  bath,  with  one 
pound  of  fait  to  every  three  gallons.  Mercurial  ointments  on 
fmall  parts  of  the  fkin  at  a  time.  A  grain  of  opium  at  night  in- 
ftead  of  the  ufual  potation  of  wine  or  beer. 

8.  Herpes.     Herpes  confifts  of  gregarious  fpreading  excoria- 
tions, which  are  fucceeded  by  branny  fcales  or  fcabs.     In  this 
difeale  there  appears  to  be  a  deficient  abforption  of  the  fubcuta- 
neous  mucus,  as  well  as  inflammation  and  increafed  fecretion  of 
it.     For  the  fluid  not  only  excoriates  the  parts  in  its  vicinity  by 
its  acrimony,  but  is  very  faline  to  the  tafte,  as  fome  of  thefe  pa- 
tients have  aflured  me  \  I  believe  this  kind  of  eruption,  as  well 
as  the  tinea,  and  perhaps  all  other  cutaneous  eruption,  is  liable 
to  be  inoculated  in  other  parts  of  the  body  by  the  finger-nails  of 
the  patients  in  fcratching  themfelves. 

It  is  liable  to  affect  the  hands,  and  to  return  at  diftant  periods  5 
and  is  probably  a  fecondary  difeafe,  as  well  as  the  zona  ignea,  or 
Ihingles,  defcribed  below. 

M.  M.  Poultice  the  eruption  with  bread  and  milk,  or  ra\r 
carrots  grated,  for  two  or  three  whole  days,  to  dilute  or  receive 
the  difcharged  fluid,  and  abate  the  inflammation  ;  then  cover  the 
parts  with  frefh  cerate  mixed  with  lapis  calaminaris.  On  the 
parts  not  excoriated  mercurial  ointment,  made  of  one  part  of 
white  calx  cf  mercury  and  fix  of  hog's  fat.  Internally,  after  vene- 

feciiozs, 


3-1$  DISEASES  CLASS  II.  i.  g.  $. 

feclion,  gentle  repeated  cathartics.  Laftly,  the  bark.  Acid  of 
vitriol.  Bolus  Armenia,  or  teftacea.  Aritimonials.  Decoc- 
tion of  interior  bark  of  elm: 

9.  Zona  ignea.  Shingles.  This  eruption  has  been  thought  a- 
fpecies  of  herpes  by  ibme  writers,  and  by  others  a  fpeeies  of 
eryfipelas.  Yellow  or  livid  veficles  appear,  producing  a  corrofive 
ichor,  which  is  fomedmes  attended  with  a  degree  of  fever.  It 
is  faid  to  infeft  fometimes  the  thorax  an'd  ribs,  but  its'  moft  gen- 
eral fituation  is  on  the  fmall  of  the  back,  over  one  kidney,  extend- 
ing forward  over  the  courfe  of  one  of  the  ureters. 

There  is  reafon  to  fufpecl,  that  this  alfo  is  a  fecondary  or  fym- 
pathetic  difeafe,  as  well  as  the  preceding  one ;  but  future 
obfervations  are  required,  before  it  can  be  removed  to  the  fourth 
clafs,  or  difeafes  of  affociation.  In  three  patients  I  have  been- 
induced  to  believe,  that  the  eruption  on  the*loi'ns  was  a  tranila- 
tron  of  inflammation  from  the  external  membrane  of  the  kidney 
to  the  fkin.  They  had,  for  a  day  or  two  before  the  appearance 
of  the  eruption,  complained  of  a  dull  pain  on  the  region  of  one 
kidney,  but  without  vomiting ;  by  which  it  was  diftinguifhed 
from  nephritis  interna,  or  gravel ;  and  without  pain  down  the 
outfide  of  the  thigh,  by  which  it  was  diftinguifhed  from  fciatica* 
In  other  fituations  the  fhingles  may  fympathize  with  other  inter- 
nal membranes,  as  in  a  cafe  publifhed  by  Dr.  Ruflel  (De  Tabe 
Glandulari),  where  the  retroceflion  of  the  ihingles  was  fucceed- 
ed  by  a  ferious  dyfpnoca.- 

M.  M.  Venefeclion,  if  the  priilfe  is  flrong.  Calomel  three  or 
four  grains,  very  mild  repeated  cathartics.  Poultice  for  a  few 
days,  then  cerate  of  lapis  calaminaris,  'as  in  herpes.  A  grain  of 
emetic  tartar  diffolved  in  a  pint  of  water,  and  taken  fo  as  to  emp- 
ty the  ftomach  and  inteftines,  is  faid  much  to  haften  the  cure ; 
compreffes  foaked  in  a  faturnine  folution  are  recommended  ex- 
ternally onthe  eruption  ;  and  cerate  where  there  are  ulcerations. 
Defanet^s  Surgical  Journal,  Vol.  II.  p.  378.  If  this  be  a  vicari- 
ous difeafe,  it  iliould  continue  half  a  lunation  ;  left,  on  its  ceaf- 
ing,  the  bad  habits  of  motion  of  the  primary  difeafe  fliouid  not 
have  been  fo  perfectly  diflevered,  but  that  they  may  recur. 

10.  Annulus  repens.       Ring- worm.      A   prurient    eruption 
formed  in  a   circle,  affecting  children,  and  would  feem  to  be  the 
work  of  infects,  according  to  the  theory  of  Linnaeus,  who  afcribes' 
the  itch  and  dyfenterv  to  microfcopic  animalcula.       Thefe  ani- 
malcula  are  probably  the  effect,  and  n6t  the  cau  fe,  of  thefe  erup- 
tions ;  as  they  are  to  be  feen  in  all  putrefcent  animal  fluids.    The 
annular  propagation  of  the  ring-worm,  and  its  continuing  to  en- 
large its  periphery,  is  well  accounted  for  by  the  acrimony  of  the' 
ichor  or  faiine  fluid  eroding  the  ikin  in  its  vicinity. 

M.  M.  Cove? 


.£LAK  il.   i.  5.   n.       OF  SENSATION.  259 

M.  M.  Cover  the  eruption  daily  with  ink.  With  white  mer- 
cmial  ointment,  asdeicribed  above  in  herpes.  "With  foiution  of 

lie  vitriol  ten  grains  to  an  ounce.  Thefe  metallic  calces  .dim- 
ul.ire  the  abforbents  into  ftronger  action,  wlience  the  fluid  lias 
its  faline  part  reabforbed,  and  that  before  it  has  acceis  to  the  air, 
which  probably  adds  to  its  acrimony  by  oxygenating  it  and  thus 
producing  a  new  acid. 

1 1.  Tinea.  Scald  head.  This  contagious  eruption  affefts 
the  roots  of  the  hair,  and  is  generally  mod  virulent  round  the 
edges  of  the  hair  on  the  back  part  of  the  head  ;  as  the  corona 
veneris  appears  moft  on  the  edges  of  the  hair  on  the  fore  part  of 
the  head  :  for  in  thefe  parts  the  eruption  about  the  roots  of  the 
hair  is  mod  expofed  to  the  external  air,  by  which  its  acrimony 
or  noxious  quality  is  increafed. 

The  abforption  of  the  matter  thus  oxygenated  fwells  the  lymph- 
atics of  the  neck  by  its  ftimulus,  occafioning  many  little  hard 
Jumps  beneath  the  feat  of  the  eruption  ;  when  this  happens,  the 
fooner  it  is  cured  the  better,  left  the  larger  lymphatic's  of  the 
neck  (hould  become  affected. 

M.  M.  The  art  of  curing  thefe  eruptions  confifls,  fifft,  in 
abating  the  inflammation,  and  confequent  fecretion  of  a  noxious 
material.  Secondly,  in  preventing  its  accefs  to  the  air,  which  fo 
much  increafes  its  acrimony.  And  thirdly,  in  promoting  the  ab- 
forption of  it,  before  it  has  been  expofed  to  the  air.  For  thefe 
purpofes  venefeclion  once,  and  gentle  cathartics,  which  promote 
abforption  by  emptying  the  blood-veffels.  Next  poultices  and 
fomentations,  with  warm  water,  abate  inflammation  by  diluting 
the  faline  acrimony  of  the  fecreted  fluid,  and  abating  the  painful 
fenfation.  Afterwards  cerate  joined  with  fome  metallic  calx,  as 
of  zinc  or  lead,  or  foiution  of  lead,  mercury,  or  copper,  or  iron, 
which  may  ftimulate  the  abforbent  fyftem  into  ftronger  action. 

Cover  the  fhaved  head  with  tar  and  fuet,  and  a  bladder  ;  this, 
by  keeping  the  air  from  the  fecreted  fluid,  much  contributes  to 
its  mildnefs,  and  the  ftimulus  of  the  tar  increafes  its  abforption. 
See  the  three  preceding  fpecies  of  this  genus. 

Mr.  Morifon  of  Dublin  cures  the  tinea  capitis'by  what  he  terms 
an  adhefive  pafte,  which  is  made  by  boiling  half  a  pound  of  fine 
flour  in  two  pounds  of  common  ale,  and  then  adding  four  ounces 
of  yellow  refin  in  fine  powder,  and  {lining  them  well  together, 
until  they  are  perfectly  incorporated.  After  removing  the  hair, 
and  poulticing  the  head  for  a  day  or  two,  to  take  off  the  hard 
fcabs,  this  patte  is  fpread  on  flips  of  linen,  which  are  applied 
over  the  whole  affected  part,  and  removed  and  frefh  ones  appli- 
ed every  morning, — after  one  or  two  days,  I  fufpecl,  that  re- 
moving the  platters  feldomer  might  be  more  advantageous. 

12.  Cru/la 


£4®  DISEASES  CLASS  II.  i.  5.  12. 

1 2.  Cntfta  lafien.     Milk-cruft  is  a  milder  difeafe  than  tinea, 
affecting  the  face  as  well  as  the  hairy  fcalp  of  very  young  chil- 
dren. It  is  not  infectious,  nor  liable  to  fwell  the  lymphatics  in  its 
vicinity  like  the  tinea. 

M.  M.  Cover  the  eruption  with  cerate  made  with  lapis  cala- 
minaris,  to  be  renewed  every  day.  Mix  one  grain  of  emetic  tar- 
tar with  forty  grains  of  chalk,  and  divide  into  eight  papers,  one 
to  be  taken  twice  a  day,  or  with  magnefia  alba,  if  (tools  are  want- 
ed. The  child  {hould  be  kept  cool  and  much  in  the  air. 

13.  Trichoma.     Plica   polonica.      A  contagious  difeafe,  in 
which  the  hair  is  faid  to  become  alive  and  bleed,  forming  inex* 
tricable  knots  or  plaits  of  great  length,  like  the  fabled  head  of 
Medufa,  with   intolerable  pain,  fo  as  to  confine  the  fufferer  QQ. 
his  bed  for  years. 


?s  II.  x.-  6.  i;         OF  SENSATION. 


ORDO    I. 

Increafed  Senfation* 

GENUS  VI. 

With  Fever  confequent  to  the  Production  of  new  Veffels  or  Fluids 

SPECIES. 

I  .  Febrisfenfttiva.  Senfitive  fever,  when  unmixed  with  either 
irritative  or  inirritative  fever,  may  be  diftinguifhed  from  either 
of  them  by  the  lefs  comparative  diminution  of  mufcular  ftrengthj 
or  in  other  words,  from  its  being  attended  with  lefs  diminution 
of  the  fenforial  power  of  irritation.  An  example  of  unmixed 
fgnfitive  fever  may  generally  be  taken  from  the  pulmonary  con- 
fumption  ;  in  this  difeafe  patients  are  feen  to  walk  about  with 
eafe,  and  to  do  all  the  common  offices  of  life  for  weeks,  and  even 
months,  with  a  pulfe  of  1  20  ftrokes  in  a  minute  ;  while  in  other 
fevers,  whether  irritated  or  inirritated,  with  a  pulfe  of  this  fre- 
quency, the  patient  generally  lies  upon  the  bed  and  exerts  no 
mufcular  efforts  without  difficulty. 

The  caufe  of  this  curious  phenomenon  is  thus  to  be  under- 
ftood  ;  in  the  fenfitive  fever  a  new  fenforial  power,  viz.  that  of 
fenfation,  is  fuperaddedto  that  of  irritation  ;  which  in  other  fevers 
alone  carries  on  the  increafed  circulation.  Whence  the  power 
of  irritation  is  not  much  more  exhaulted  than  in  health  ;  and 
thofe  mufcular  motions,  which  are  produced  in  confequence  of 
it,  as  thofe  which  are  exerted  in  keeping  the  body  upright  in 
walking,  riding,  and  in  the  performance  of  many  cufhomary  ac- 
tions, are  little  impaired.  For  an  account  of  the  irritated  ienfi- 
tive  fever,  fee  Clafs  II.  i.  2.  i.  ;  for  the  inirritated  fenfitive  fever, 
ClafsII.  i.  3.  i.  IV.  2.  4.  ii. 

2.  Febris  a  pure  claiifb.  Fever  from  enclofed  matter  is  gener- 
ally of  the  irritated  fenfitive  kind,  and  continues  for  many  weeks, 
and  even  months,  after  the  abfcefs  is  formed  ;  but  is  didinguifh- 
ed  from  the  fever  from  aerated  matter  in  open  ulcers,  becaufe 
there  are  feldom  any  night-fweats,  or  colliquative  diarrhcea  in 
this,  as  in  the  latter.  The  pulfe  is  alfo  harder,  and  requires  oo 
cafional  venefetlion,  and  cathartics,  to  abate  the  inflammatory 
fever  ;  which  is  liable  to  increafe  again  every  three  or  four  days, 
till  at  length,  unlefs  the  matter  has  an  exit,  it  deflroys  the  patient. 
In  this  fever  the  matter,  not  having  been  expofed  to  the  air,  has 
riot  acquired  oxygenation  ;  in  which  a  new  acid,  or  lome  other 

VOL.  II.  H  H  rioxiout 


242  DISEASES  CLASS  II.  r.  6.  ^ 

noxious  property,  is  produced ;  which  acls  like  contagion  on  the 
conftitution  inducing  fever-fits,  called  hectic  fever,  which  termin- 
ate with  fweats  or  diarrhoea  ;  whereas  the  matter  in  the  clofed 
abfcefs  is  either  not  abforbed,  or  does  not  fo  affect  the  circula- 
tion as  to  produce  diurnal  or  he&ic  fever-fits  5  but  the  ftimulus 
of  the  abfcefs  excites  fo  much  fenfation  as  to  induce  perpetual 
pyrexia,  or  inflammatory  fever,  without  fuch  marked  remiiuons. 
Ncverthelefs  there  fometimes  is  no  fever  produced,  when  the 
inatteris  lodged  in  a  part  of  little  fenfibility,  as  in  the  liver ;  yet 
a  white  pus-like  fediment  in  thofe  cafes  exifts  I  believe  general- 
ly in  the  urine,  with  occafional  wandering  pains  about  the  region 
of  the  liver  or  cheft. 

3,  Vomica.     An  abfcefs  in  the  lungs  is  fometimes  produced 
after  peripneumony,  the  cough  and  fhortnefs  of  breath  continue 
in  lets  degree,  with  difficulty  in  lying  on  the  well  fide,  and  with 
fenfitive  irritated  fever,  as  explained  in  the  preceding  article. 

The  occafional  increafe  of  fever,  with  hard  pulfe  and  fizy 
blood,  in  thefe  patients,  is  probably  owing  to  the  inflammation 
of  the  walls  of  the  vomica  ;  as  it  is  attended  with  difficulty  of 

breathing,  and  requires  venefeclion*  Mr.  B j  a  child  about 

feven  years  old,  lived  about  feven  weeks  in  this  fituation,  with  a 
pulfe  from  150  to  170.  in  a  minute,  without  fweats,  or  diarrhoea, 
or  fediment  in  his  water,  except  mucus  occafionally;  and  took 
fufHcienjL  nourimment  during  the  whole  time.  The  blood  ta- 
ken was  always  covered  with  a  ftrong  cupped  fize,  and  on  his 
death  three  or  four  pints  of  matter  were  found  in  one  fide  of  the 
cheft  ;  which  had  probably,  but  lately,  been  effufed  from  a  vom- 
ica. This  child  was  frequently  induced  to  fwing,  both  in  a  re- 
ciprocating and  in  a  rotatory  fwing,  without  any  apparent  abforp- 
tion  of  matter ;  in  both  thefe  fwings  he  exprefled  pleafure,  and 
did  not  appear  to  be  vertiginous. 

M.  M.  Repeated  emetics.  Digitalis  ?  Perfeverance  in  ro- 
tatory fwinging.  SeeClafs  II.  I.  6.  7. 

Mr.  I.  had  laboured  fome  months  under  a  vomica  after  a  pe- 
ripneumoiiy,  he  was  at  length  taken  with  a  catarrh,  which  was  in 
feme  degree  endemic  in  March  1795,  which  occafioned  him  to 
fneeze  much,  during  which  a  copious  haemorrhage  from  the  lungs 
occurred,  and  he  fpit  up  at  the  fame  time  half  a  pint  of  very  fe- 
tid matter,  and  recovered.  Hence  errhines  may  be  occafionally 
a  fed  with  advantage. 

4.  JSmpyema.     When  the  matter  from  an  abfcefs  in  the  lungs 
finds  its  way  into  the  cavity  of  the  cheft,  it  is  called  an  empye- 
nia.     A  fervant  man,  after  a  violent  peripneumony,  was  feized 
with  fymptoms  of  empyema,  and  it  was  determined,  after  fome 
lime,  to  perform  the  operation  ;  this  was  explained  to  him,  and 

the 


CLASS  II.  1.6.5.        OT  SENSATION.  143 

the  ufual  means  were  employed  by  his  friends  to  encourage  him, 
«  by  advifing  him  not  to  be  afraid."  By  which  good  advice  Le 
conceived  fo  much  fear,  that  he  ran  away-early  next  morning, 
and  returned  in  about  a  week  quite  well.  Did  the  great  fear 
promote  the  abforption  of  the  mutter,  like  the  ficknefs  occafion- 
cd  by  digitalis  ?  Fear  renders  the  external  ikin  pale  j  by  this 
continued  decreafe  of  the  action  of  the  abforbents  of  the  fldn 
might  not  thofe  of  the  lungs  be  excited  into  greater  activity  ': 
thus  produce  increafecl  pulmonary  abforption  by  reverie  iympa- 
thy,as  it  produces  pale  urine, and  even  flools,by  direct  fympathy? 
M.  M.  Digitalis  ? 

5.  Febris  Mefenterica.     Fever  from  matter  formed  in  the  mef~ 
cntery  is  probably  more  frequent  than  is  fufpected.     It  commen- 
ces with  pain  in  the  bowels,  with  irritated  fenfitive  fever ;  and 
continues  many  weeks,  and  even  months,  requiring  oecafional 
venefection,  and  mild  cathartics;  till  at  length  the  continuance 
of  the  pyrexia,  or  inflammatory  fever,  deflroys  the  patient.  This 
is  an  affection  of  the  lymphatic  glands,  and  properly  belongs  to 
fcrofula  ;  but  as  the  matter  is  not  expofed  to  the  air,  no  hectic 
fever,  properly  fo  called,  is  induced. 

6.  Febris  a  pure  aerato.     Fever  from  aerated  matter.     A  great 
collection  of  matter  often  continues  a  long  time,  and  is  fome- 
times  totally  abforbed,  even  from  venereal  buboes,  without  pro- 
ducing any  diforder  in  the  arterial  fyftem.     At  length,  if  it  be- 
comes putrid  by  its  delay,  and  one  part  of  the  matter  thus  be- 
comes aerated  by  the  air  given  out  by  the  other  part ;  or  if  the 
ulcer  has  been  opened,  fo  that  any  part  of  it  has  been  expofed 
to  the  air  for  but  one  day,  a  hectic  fever  is  produced.     Whence 
the  utility  arifes  of  opening  large  abfcefles  by  fetons,  as  in  that 
cafe  little  or  no  hectic  fever  is  induced  ;  becaufe  the  matter  is 
Squeezed  out  by  the  fide  of  the  fpongy  threads  of  cotton,  and  lit- 
tle or  no  air  is  admitted  ;  or  by  tapping  the  abfcefs  with  a  tro- 
car, as  mentioned  in  ifchias,  Clafs  II.  1.2-  18. 

In  this  fever  the  pulfe  is  about  1 20  in  a  minute,  and  its  accefg 
is  generally  in  an  evening,  and  fometimes  about  noon  alfo,  with 
fweats  or  purging  towards  morning,  or  urine  with  pus- 
like  fediment  -,  and  the  patients  bear  this  fever  better  than 
any  other  with  fo  quick  a  pulfe  :  and  laftly,  when  all  the  matter 
from  a  concealed  ulcer  is  abforbed,  or  when  an  open  ulcer  is  heal- 
ed, the  hectic  fever  ceafes.  Here  the  abforbed  matter  is  fuppo- 
fed  to  produce  the  fever,  and  the  diarrhoea,  fweats,  or  copious 
muddy  urine,  to  be  fimply  the  confequence  of  increafed  fecretion, 
and  not  to  confift  of  the  purulent  matter,  which  was  fuppofed  to 
fce  abforbed  from  the  ulcer.  See  Sudor  calidus,  Clafs  I.  i.  2.  3. 

The  action  of  the  air  oa  ulcers,  as  we  have  already  (hewn,  in* 

creafei 


?44  DISEASES  Clafs  II.  r.  6.  6. 

creafes  the  acrimony  of  the  purulent  matter,  and  even  converts 
it- into  a  weaker  kind  of  contagious  matter  ;  that  is,  to  a  mate- 
rial inducing  fever.  This  was  afcribed  to  the  union  of  the  azotic 
part  of  the  atmofphere  with  the  effufed  pus  in  Seel:.  XXVIII.  2. 
but  by  contemplating  more  numerous  facets  and  analogies,  I  am 
pow  induced  to  believe,  that  it  is  by  the  union  of  oxygen  with  it ; 
firft,becaufe  oxygen  fo  greedily  unites  with  other  animal  fubftances, 
as  the  blood,  that  it  will  pafs  through  a  moift  bladder  to  combine 
with  it,  according  to  the  experiment  of  Dr.  Prieftley.  Secondly^ 
becaufe  the  poifons  of  venomous  creatures  are  fuppofed  to  bd 
acids  of  different  kinds,  and  are  probably  formed  by  the  conta£b 
of  air  after  their  fecretion.  And  laflly,  becaufe  the  contagious 
matter  from  other  ulcers,  as  in  itch,  or  fmall-pox,  is  formed  ori 
external  membranes,  and  are  probably  combinations  of  animal 
matter  and  oxygen,  producing  other  new  acids. 

Since  having  written  the  above,  Dr.  Mitchill,  of  New  York, 
has  fpoken  much  of  the  feptic  quality  ©f  azote,  or  nitrogen  ;  and 
thinks  that  it  is  the  union  of  this  part  of  the  atmofphere  with 
the  matter  of  ulcers,  which  produces  or  increafes  its  contagious 
or  fever-exciting  property  j  which  I  had  myfelf  at  firfl  believed,' 
as  mentioned  jn  Part  I.  Seel:  XXVIII.  2.  In  fupport  of  this 
opinion,  it  may  be  faid,  that  proper  ventilation  with  purer  air  is 
believed  certainly  to  diminifh  or  deflroy  infection  ;  as  fpoken  of 
in  Clafs  II.  i.  3.  where  it  is  propofed  to  difengage  oxygen  from 
manganefe,  for  the  purpofe  of  purifying  crowded  apartments. 
But  further  experiments  muft  determine  this  curious  inquiry  ; 
which  might  be  attended  with  important  confequences^f  azote, 
and  not  oxygen,  could  be  fhewn  to  prevent  the  healing  of  pul- 
monary ulcers  ;  as  oxygen  might  be  refpired  alone,  or  mixed 
with  hydrogen  or  with  carbonic  acid  gas,  inftead  of  with  azote. 

It  was  thought  a  fubjecl:  of  confequence  by  the  jEfculapian 
Society  at  Edinburgh,  to  find  a  criterion  which  fhould  diftin- 
guifh  pus  from  mucus,  for  the  purpofe  of  more  certainly  dif- 
covering  the  prefence  of  ulcers  in  pulmonary  difeafes,  or  in, 
the  urinary  paflages.  For  this  purpofe  that  fpciety  offer- 
ed their  firft  gold  medal,  which  was  conferred  on  the  late  Mr. 
Charles  Darwin,  in  the  year  1778,  for  his  experiments  on  this 
fubjecl:.  From  which  he  deduces  the  following  conclufions  : 

"  i.  Pus  and  mucus  are  both  foluble  in  the  vitriolic  acid, 
though  in  very  different  proportions,  pus  being  much  the  lefs 
ibluble. 

"  2.  The  addition  of  water  to  either  of  thefe  compounds  de- 
compofes  it ;  the  mucus  thus  feparated,  either  fwims  on  the  mix- 
ture, or  forms  large  ilocci  in  it ;  whereas  the  pus  falls  to  the 
bottom,  and  forms  on  agitation  a  uniform  turbid  mixture.  « 

«  3.  Pus 


CLASS  II.  i.  6.  7.  OF  SENSATION.  145 

«  3.  Pus  is  diffufible  through  a  diluted  vitriolic  ncid,  though 
mucus  is  not ;  the  fame  occurs  with  water,  or  a  folution  of  fea 
fait. 

«  4.  Nitrous  acid  diflolves  both  pus  and  mucus  ;  water  added 
to  the  folution  of  pu£  produces  a  precipitate  ;  and  the  fluid  a- 
bove  becomes  clear  and  green  ;  while  water  and  the  folution  of 
mucus  form  a  dirty  coloured  fluid. 

"  5.  Alkaline  lixivium  diflolves  (though  fometimes  with  dini- 
jculty)  mucus,  and  generally  pus. 

"  6.  Water  precipitates  pus  from  fuch  a  folution,  but  does  not 
jmicus. 

"  7.  Where  alkaline  lixivium  does  not  diflblve  pus,  it  ftill  dif- 
tinguimes  it  from  mucus ;  as  it  then  prevents  its  diiFufion  through 
water. 

"  8.  Coagulable  lymph  is  neither  foluble  in  diluted  nor  con- 
centrated vitriolic  acid. 

"  9.  Water  produces  no  change  on  a  folution  of  ferum  in  al- 
kaline lixivium,  until  after  long  (landing,  and  then  only  a  very 
/light  fediment  appears. 

"  10.  Corrofive  fublimate  coagulates  mucus,  but  not  pus. 

"  From  the  above  experiments  it  appears,  that  ftrong  vitri- 
olic acid  and  water,  diluted  vitriolic  acid,  and  cauftic  alkaline 
lixivium  and  water,  will  ferve  to  diftinguim  pus  from  mucus ; 
that  the  vitriolic  acid  can  feparate  it  from  coagulable  lymph,  and 
alkaline  lixivium  from  ferum. 

"  And  hence,  when  a  perfon  has  any  expectorated  material, 
the  compofition  of  which  he  wifhes  to  afcertain,  let  him  diflblve  it 
in  vitriolic  acid,  and  in  cauftic  alkaline  lixivium  ;  and  then  add 
pure  water  to  both  folutions  :  and  if  there  is  a  fair  precipitation  in 
each,  he  may  be  aflured  that  fome  pus  is  prefent.  If  in  neither  a 
precipitation  occurs,  it  is*  a  certain  teft,  that  the  material  is  en- 
tirely mucus.  If  the  material  cannot  be  made  to  diflblve  in  al- 
kaline lixivium  by  time  and  trituration,  we  have  alfo  reafon  to  be- 
lieve that  it  is  pus."  Experiments  on  Pus  and  Mucus.  Cadell. 
London. 

Dr.  Cappe,  of  York,  in  his  inaugural  treatife  de  Heclica,  and 
Dr.  Ryan,  of  Dublin,  in  his  Eflay  on  Confumption,  have  repeat- 
ed thefe  experiments  of  Mr.  Darwin  with  nearly  fimilar  refults. 

7.  Pbthijis  pulmonalis.  In  pulmonary  confumption  the  fever 
is  generally  fuppofed  to  be  the  confequence  of  the  ftimulus  of 
abforbed  matter  circulating  in  the  blood- veflels,  and  not  fimply 
of  its  (limulus  on  their  extremities  in  the  furface  of  the  ulcers  ; 
as  mentioned  in  Clafs  II.  i.  5.  and  Clafs  II.  i.  3.  9.  The  ul- 
cers are  probably  fometimes  occafioned  by  the  putrid  acrimony 
<rf  effufed  blood  remaining  in  the  air-cells  of  the  lungs  after  an 

hsemoptoe. 


246  DISEASES  CLASS  II.  i.  6".  7. 

fisemcptoe.  Sec  Clafs  I.  2.  i.  9.  The  remote  eaufe  of  con- 
fumption  is  ingenioufly  afcribed  by  Dr.  Beddoes  to  the  hyper- 
oxygenation  of  the  blood,  as  mentioned  Section  XXVIII.  2. 

As  the  patients  liable  to  confumption  are  of  the  inirritable 
temperament,  as  appears  by  the  large  pupils  of  their  eyes  ;  there 
is  reafon  to  believe,  that  the  haemoptoe  is  immediately  occafioned 
by  the  deficient  abforption  of  the  blood  at  the  extremities  of  the 
bronchial  vein  ;  and  that  one  difficulty  of  healing  the  ulcers  is 
occafioned  by  the  deficient  abforption  of  the  fluids  effufed  into 
them.  See  Sett  XXX.  i.  and  2" 

The  difficulty  of  healing  pulmonary  ulcers  may  be  owing,  as 
its  remote  caufe,  to  the  inceflhnt  motion  of  all  the  parts  of  the 
lungs  ;  whence  no  fcab,  or  indurated  mucus,  can  be  formed  fo 
as  to  adhere  on  them.  Whence  thefe  naked  ulcers  are  perpet- 
ually expofed  to  the  action  of  the  air  on  their  furfaces,  conver- 
ting their  mild  purulent  matter  into  a  contagious  ichor  ;  which 
not  only  prevents  them  from  healing,  but  by  its  action  on  their 
circumferences,  like  the  matter  of  itch  or  tinea,  contributes  to 
fpread  them  wider.  See  the  preceding  article,  and  Seel.  XXXIII. 
2.  7.  where  the  pulmonary  phthifis  is  fuppofed  to  be  infectious. 
This  acidifying  principle  is  foun4  in  all  the  metallic  calces, 
as  in  lapis  calaminaris,  which  is  a  calciform  ore  of  zinc  ; 
and  in  minium,  which  is  a  calx  of  lead  ;  two  materials 
which  are  powerful  in  healing  excoriations  and  -  ulcers,  in  a 
fhort  time,  by  their  external  application.  How  then  does  it 
happen,  that  the  oxygen  in-  the  atmofphere  fhould  prevent  pul- 
monary ulcers  from  healing,  and  even  induce  them  to  fpread 
wider  ;  and  yet  in  its  combination  with  metals,  it  (hould  facili- 
tate their  healing  ?  The  healing  of  ulcers  confifts  in  promoting 
the  abforption  of  the  fluids  effufed  into  them,  as  treated  of  in 
Section  XXXIII.  3.  2.  Oxygen  in  combination  with  metals, 
•when  applied  in  certain  quantity,  produces  this  effect  by  its 
ftimulus  ;  and  the  metallic  oxydes  not  being  decompofed  by 
their  contact  with  animal  matter,  no  new  acid,  or  contagious 
material,  is  produced.  So  that  the  combined  oxygen,  when  ap- 
plied to  an  ulcer,  fimply  I  fuppofe  promotes  abforption  in  it, 
like  the  application  of  other  materials  of  the  articles  forbentia  or 
incitantia,  if  applied  externally  ;  as  opium,  bark,  alum.  But 
in  the  pulmonary  ulcers,  which  cannot  protect  themfelves  from 
the  air  by  forming  a  fcab,  the  uncombined  oxygen  of  the  atmof- 
phere unites  with  the  purulent  matter,  converting  it  into  a  con- 
tagious ichor  ;  which  by  infection,  not  by  erofion,  enlarges 
the  ulcers,  as  in  the  itch  or  tinea  ;  which  might  hence,  accor- 
ding to  Dr.  Beddoes's  ingenious  theory  of  confumption,  be  in- 
duced to  heal,  if  expofed  to  an  atrnofphere  deprived  of  a  part  of  its 

oxygen. 


Clafs  II.  i.  6.  7.        OF  SENSATION.  147 

oxygen.  1f6s  I  hope  future  experiments  will  confirm,  and 
that  the  pneumatic  medicine  will  alleviate  the  evils  of  mankind 
in  many  other,  as  well  as  in  this  moil  fatal  malady. 

M.  M.  Firfl,  the  refpiration  of  air  lowered  by  an  additional 
quantity  of  azote,  or  mixed  with  fome  proportion  of  hydrogen, 
or  of  carbonic  acid  air,  may  be  tried  ;  as  described  in  a  late  pub- 
lication of  Dr.  Beddoes  o>  the  medicinal  ufe  of  factitious  airs, 
Johnfon,  London.  Or  lailly,  by  breathing  a  mixUire  of  one- 
tenth  part  of  hydrocarbonate  mixed  with  common  air,  according. 
to  the  difcovery  of  Mr.  Watt,  which  has  a  double  advantage  in 
thefe  cafes,  of  diluting  the  oxygen  of  the  atmofpheric  air,  and 
inducing  ficknefs,  which  increafes  pulmonary  abforption,  as 
mentioned  below.  An  atmofphere  diluted  with  fixed  air  (car- 
bonic acid)  might  be  readily  procured  by  fetting  tubs  of  new 
wort,  or  fermenting  beer,  in  the  parlour  and  lodging-room  of  the 
patient.  For  it  is  not  acids  floating  in  the  air,  but  the  oxygen 
or  acidifying  principle,  which  injures  or  enlarges  pulmonary  ul- 
cers by  combining  with  the  purulent  matter. 

Another  eafy  method  of  adding  carbonic  acid  gas  to  the  air 
of  a  room,  would  be  by  means  of  an  apparatus  invented  by  Mr. 
Watt,  and  fold  by  Bolton  and  Watt,  at  Birmingham,  as  defcri- 
becl  in  Dr.  Beddoes'  Treatife  on  Pneumatic  Medicine.  John- 
fon, London.  It  confifts  of  an  iron  pot,  with  an  arm  projecting, 
and  a  method  of  letting  water  drop  by  flow  degrees  on  chalk, 
-which  is  to  be  put' into  the  iron  pot,  and  expofed  to  a  moderate 
degree  of  heat  over  a  common  fire.  By  occafionally  adding  more 
and  more  chalk,  carbonic  acid  gas  might  be  carried  through  a 
tin  pipe  from  the  arm  of  the  iron  pot  to  any  part  of  the 
room  near  the  patient,  or  from  an  adjoining  room.  In  the  fame 
manner  a  difFuiion  of  folution  of  flowers  of  zinc  might  be  pro- 
duced and  breathed  by  the  patient,  and  would  be  likely  much  to 
contribute  to  the  healing  of  pulmonary  ulcers  ;  as  obferved  by 
Mr.  Watt.  See  the  treatife  above  mentioned. 

Breathing  over  the  rapour  of  cauftic  volatile  alkali  might  eaflly 
be  managed  for  many  hours  in  a  day  ;  which  might  neutralize 
the  acid  poifon  formed  on  pulmonary  ulcers  by  the  contact  of 
oxygen,  and  thus  prevent  its  deleterious  quality,  as  other  acids 
become  lefs  cauftic,  when  they  are  formed  into  neutral  falts  with 
alkalis.  The  volatile  fait  (hould  be  put  into  a  tin  canifter,  with 
two  pipes  like  horns  from  the  top  of  it,  one  to  fuck  the  air  from, 
and  the  other  to  admit  it. 

Secondly,  the  external  ulcers  in  fcrofulous  habits  are  pale  and 
flabby,  and  naturally  difmclined  to  heal,  the  depofition  of  fluids 
in  them  being  greater  than  the  abforption  ;  thefe  ulcers  have 
their  appearance  immediately  changed  by  the  external  application 

of 


DISEASES  CtfAis  IT.  i.  6.  ^ 

of  metallic  calx'es,  and  the  medicines  of  the  article  Sorbentia, 
fuch  as  cerufla  and  the  bark  in  fine  powder,  fee  Clafs  I.  2.  3.  21.' 
and  are  generally  healed  in  a  (hort  time  by  thefe  means.  Indu- 
ced by  thefe  obfervatiohs,  I  wifhed  to  try  the  external  application 
of  fuch  powders  to  ulcers  in  the  lungs,  and  conitrucled  a  box 
with  a  circulating  brufti  in  it,  into  this  box  two  ounces  of  fine 
powder  of  Peruvian  bark  were  put,  and  two  drachms  of  cerufla 
in  fine  powder  ;  on  whirling  the  central  brufh,  part  of  this  was 
raifed  into  a  cloud  of  powder  and  the  patient,  applying  his  mouth 
to  one  of  the  tin  pipes  rifirig  out  of  the  box,  inhaled  this  powder 
twice  a  day  into  his  lungs.  I  obferved  it  did  not  produce  any 
cough  or  uneafmefs.  This  patient  was  in  the  laft  ilage  of  con- 
iumption,  and  was  fcon  tired  of  the  experiment,  nor  have  I  had 
Aich  patients  as  I  wifhed  for  the  repetition  of  it.  Perhaps  a 
fine  powder  of  manganefe,  or  of  the  flowers  of  zinc,  or  of  lapis 
calaminaris,  might  be  thus  applied  to  ulcers  of  the  lungs 
with  greater  advantage  ?  Perhaps  air  impregnated  with  flowers 
of  zinc  in  their  mod  comminuted  flate,  might  be  a  better  way  of 
applying  this  powder  to  the  lungs,  as  difcovered  by  Mr.  Watt. 
See  Dr.  Beddoes  on  Pneumatic  Medicine.  Johnfon. 

Thirdly,  as  the  healing  of  an  ulcer  confifls  in  producing  a 
tendency  to  abforption  on  its  furface  greater  than  the  depofitiort 
on  it  •,  fee  Seel.  XXXIII.  3.  2.  Other  modes  of  increafing  pul- 
monary abforption,  which  are  perhaps  more  manageable  than 
the  preceding  ones,  may  be  had  recourfe  to  ;  fuch  as  by  pro- 
ducing frequent  naufea  or  ficknefs,  See  Seel.  XXIX.  5.  i.  and 
Art.  IV.  2.  The  great  and  hidden  abforption  of  fluid  from  the 
lungs  in  the  anafarca  pulmonum  by  the  ficknefs  induced  by  the 
exhibition  of  digitalis,  aftonifhes  thofe  who  have  not  before  at- 
tended to  it,  by  emptying  the  fwelled  limbs,  and  removing  the 
difficulty  of  breathing  in  a  few  hours. 

The  moil  manageable  method  of  ufirrg  digitalis  is  by  making, 
a  faturated  tinelure  of  it,  by  infufing  two  ounces  of  the  powder 
of  the  leaves  in  a  mixture  of  four  ounces  of  rectified  fpirit  of 
wine,  and  four  ounces  of  water.  Of  this  from  30  to  60  drops,  or 
upwards,  from  a  two-ounce  phial,  are  to  be  taken  twice  in  the 
morning  part  of  the  day,  and  to  be  fo  managed  as  not  to  induce 
violent  ficknefs.  If  ficknefs  neverthelefs  conies  on,  the  patient 
muft  for  a  day  or  two  omit  the  medicine  ;  and  then  begin  it 
again  in  reduced  dofes. 

Mr.  ,  a  young  man  about  twenty,  with  dark  eyes  and 

large  pupils,  who  had  every  fymptom  of  pulmonary  ulcers,  I 
believed  to  have  been  cured  by  digitalis,  and  publimed  the  cafe 
in  the  Tranfaclions  of  the  College,  Vol.  III.  But  I  heard, 
that  about  two  years  afterwards  he  relapfed  and  died.  Mr. 


CLASS  U.  i.  6.  7.          OF  SENSATION.  245} 

L ,  a  corpulent  man,  who  had  for  fome  weeks  laboured 

under  a  cough  with  great  expectoration,  with  quick  pulfe,  and 
difficulty  of  breathing,  foon  recovered  by  the  ufe  of  digitalii 
taken  twice  a  day  j  and  though  this  cafe  might  probably  be  a 
peripneumonia  notha,  or  catarrh,  it  is  here  related  as  (hewing 
the  power  of  pulmonary  abforption  excited  by  the  ufc  of  this 
drug. 

Since  the  publication  of  the  above5  fome  fuccefsful  cafes  of 
the  treatment  of  confumption  by  the  tinfture  of  digitalis  are  re- 
lated in  Medical  and  Phyfical  Contributions,  edited  by  Dr.  Bed- 
does,  Longman,  London.  Two  of  the  fuccefsful  cafes  are  from 
Dr.  Drake,  who  obferves,  "  that  by  gradually  increafing  the  dofe 
of  the  faturated  tin&ure  of  digitalis  from  20  drops  to  100  twice 
a  day,  all  the  fymptoms  of  fever,  cough,  pain,  and  dyfpncea,  daily 
grew  better,  and  at  length  totally  ceafed,  and  that  on  the  quanti- 
ty and  quality  of  the  expectorated  matter  the  digitalis  foon  exert- 
ed a  very  remarkable  effe£t,  either  promoting  its  abforption,  or 
diminifhing  its  fecretion,  or  perhaps  both,  in  a  rapid  manner  j 
while  at  the  fame  time  it  deprived  it  of  its  fetor."  Many  cafes 
with  great  relief,  or  with  profperous  event,  are  related  byDr. 
Fowler,  and  by  Dr.  Beddoes.  One  I  have  alfo  lately  feen  my- 
felf,  whom  I  believed  to  be  confumptive,  and  who  is  of  a  con- 
fumptive  family,  and  after  having  ufed  the  faturated  tincture 
about  fix  weeks,  or  two  months,  in  various  dofes,  is  now  believed 
by  herfelf  and  friends  to  be  perfectly  reftored  to  health,  but  there 
has  not  been  time  enough  yet  elapfed  to  determine,  whether  (he 
may  not  relapfe,  now  me  difcontinues  the  medicine. 

Neverthelefs  as  the  digitalis  has  been  given  in  many  cafes 
without  fuccefs,  there  is  reafon  to  believe,  that  it  mould  be  taken 
early  in  the  difeafe,  before  too  great  ulcerations  are  produced, 
and  too  great  debility  exifts.  As  thefe  patients  are  fubjett  to 
flatter  themfelves  more  than  mod  others,  and  are  liable,  on  that 
account,  not  to  apply  foon  enough  for  proper  adiftance,  they 
mould  be  warned  that  a  cough  attended  with  a  pulfe,  that  beats 
1 20  times  in  a  minute,  is  always  a  difeafe  of  danger. 

Another  method  of  inducing  ficknefs,  and  pulmonary  abforp- 
tion in  confequence,  is  by  failing  on  the  fea  ;  by  which  many 
confumptive  patients  have  been  faid  to  have  received  their  cure  i 
which  has  been  erroneoufly  afcribed  to  fea-air,  initead  of  fea- 
ficknefs  ;  whence  many  have  been  fent  to  breathe  the  fea-air  on 
the  coafts,  who  might  have  done  better  in  higher  fituations,  where 
the  air  probably  contains  lefs  oxygen  gas,  which  is  the  heaviest 
part  of  it.  See  a  Letter  from  Dr.  J.  C.  below. 

A  third  method  of  inducing  ficknefs,  and  confequent  pulmo- 
nary abforption,  is  by  the  vertigo  occafioncd  by  f winging  ;  which 

VOL.  II.  I  i  hat 


DISEASES  CLASS  II.  x.  6. 7. 

has  lately  been  introduced  into  practice  by  Dr.  Smith,  (Eflay  on 
Pulmonary  Confcimption),  who  obferved  that  by  Twinging  the 
hectic  pulfe  became  flower,  which  is  explained  in  Clafs  IV.  2. 
i.  10.  The  ufual  way  of  reciprocating  fwinging,  like  the  of- 
cillations  of  a  pendulum,  produces  a  degree  of  vertigo  in  thofe, 
who  are  unufed  to  it ;  but  to  give  it  greater  effect,  the  patient 
(hould  be  placed  in  a  chair  fufpended  from  the  ceiling  by  two 
parallel  cords  in  contact  with  each  other,  the  chair  fhould  then 
be  forcibly  revolved  20  or  40  times  one  way,  and  fuffered  to  re- 
turn fpontaneoufly  ;  which  induces  a  degree  of  ficknefs  in  moft 
adult  people,  and  is  well  worthy  an  exact  and  pertinacious  trial, 
for  an  hour  or  two,  three  or  four  times  a  day  for  a  month. 

The  common  means  of  promoting  abforption  in  ulcers,  and 
of  thickening  the  matter  in  confequence,  by  taking  the  bark 
and  opium  internally,  or  by  metallic  falts,  as  of  mercury, 
fleel,  zinc,  and  copper,  in  fmall  quantities,  have  been  repeatedly 
ufed  in  pulmonary  confumption  ;  and  may  have  relieved  fome 
of  the  fymptoms.  As  mercury  cures  venereal  ulcers,  and  as  pul- 
monary ulcers  refemble  them  in  their  not  having  a  difpofition  to 
heal,  and  in  their  tendency  to  enlarge  themfelves,  there  were 
hopes,  from  analogy,  that  it  might  have  fucceeded.  Would  a 
folution  of  gold  in  aqua  regia  be  worth  trying  ?  When  vinegar 
is  applied  to  the  lips,  it  renders  them  mftantly  pale,  by  promo- 
ting the  venous  abforption  ;  if  the  whole  fkin  was  moiflened  with 
warmifli  vinegar,  would  this  promote  venous  abforption  in  the 
lungs  by  their  fympathy  with  the  fkin  ?  The  veryabftemious  di- 
et on  milk  and  vegetables  alone  is  frequently  injurious.  Flefli 
meat  once  a  day,  with  fmall  wine  and  water,  or  fmall  beer,  is  pref- 
erable. Half  a  grain  of  opium  twice  a  day,  or  a  grain,  I  believe 
to  be  of  great  ufe  at  the  commencement  of  the  difeafe,  as  appears 
from  the  fubfequent  cafe. 

Mifs  — ,  a  delicate  young  lady,  of  a  confumptive  family, 
when  fhe  was  about  eighteen,  had  frequent  cough,  with  quick 
pulfe,  a  pain  of  her  fide,  and  the  general  appearances  of  a  begin- 
ning confumption.  She  took  about  five  drops  of  laudanum 
twice  a  day  in  afaline  draught,  which  wasincreafed  gradually  to 
ten.  In  a  few  weeks  fhe  recovered,  was  afterwards  married, 
bore  three  or  four  children,  and  then  became  confumptive  and 
died. 

The  following  cafe  of  hereditary  comfumption  is  related  by 
a  phyfician  of  great  ability  and  very  extenfive  practice  -,  and,  as 
it  is  his  own  cafe,  abounds  with  much  nice  obfervation  and  ufe- 
ful  knowledge  j  and,  as- it  has  been  attended  with  a  favourable 
event,  may  give  confolation  to  many,  who  are  in  a  fimilar  fitua- 
tioij  and  {hews  that  Sydenham's  recommendation  of  riding  as 


CLASS  II.  i.  6.  7.        OF  SENSATION.  251 

a  cure  for  confumption  is  not  fo  totally  ineffectual,  as  is  now 
commonly  believed. 

J.  C.  aged  27,  with  black  hair,  and  a  ruddy  complexion,  was 
fubjecl:  to  cough  from  the  age  of  puberty,  and  occafionally  to 
fpitting  of  blood.  His  maternal  grandfather  died  of  confump- 
tion under  thirty  years  of  age,  and  his  mother  fell  a  victim  to 
this  difeafe,  with  which  fhe  had  long  been  threatened,  in  her 
43d  year,  and  immediately  after  (he  ceafed  to  have  children.  In 
the  fevere  winter  of  1783-4,  he  was  much  afflicted  with  cough ; 
and  being  expofed  to  intenfe  cold,  in  the  month  of  February  he 
was  feized  with  peripneumony.  The  difeafe  wrs  violent  and 
dangerous,  and  after  repeated  bleedings  as  well  as  blifterings, 
•which  he  fupported  with  difficulty,  in  about  fix  weeks  he  was 
able  to  leave  his  bed.  At  this  time  the  cough  was  fevere,  and 
the  expectoration  difficult.  A  fixed  pain  remained  on  the  left 
fide,  where  an  iflue  was  inferted  ;  regular  hectic  came  on  every- 
day about  an  hour  after  noon,  and  every  night  heat  and  reftlefT- 
nefs  took  place,  fucceeded  towards  morning  by  general  perfpi- 
ration. 

The  patient,  having  formerly  been  fubject  to  ague,  was  flruck 
with  the  refemblance  of  the  febrile  paroxyfm,  with  what  he  had 
experienced  under  that  difeafe,  and  was  willing  to  flatter  himfelf  it 
might  be  of  the  fame  nature.  He  therefore  took  bark  in  the  in- 
terval of  fever,  but  with  an  increafe  of  his  cough,  and  this  requir- 
ing venefection,  the  blood  was  found  highly  inflammatory.  The 
vait  quantity  of  blood  which  he  had  loft  from  time  to  time,  pro- 
duced a  difpofition  to  fainting,  when  he  refumed  the  upright 
pofture,  and  he  was  therefore  obliged  to  remain  almoft  conftant- 
ly  in  a  recumbent  pofition.  Attempting  to  ride  out  in  a  carriage, 
he  was  furprifed  to  find  that  he  could  fit  upright  for  a  confider- 
able  time,  while  in  motion,  without  inconvenience,  though,  on 
flopping  the  carriage,  the  difpofition  to  fainting  returned. 

At  this  time,  having  prolonged  his  ride  beyond  the  ufual 
length,  he  one  day  got  into  an_  uneven  road  at  the  ufual  period 
of  the  recurrence  of  the  hectic  paroxyfms,  and  that  day  he  mifP- 
ed  it  altogether.  This  circumftance  led  him.  to  ride  out  daily 
in  a  carriage  at  the  time  the  febrile  acceflion  might  be  expected, 
and  fometiroes  by  this  means  it  was  prevented^  fometimes  de- 
ferred, and  almoft  always  mitigated. 

This  experience  determined  him  to  undertake  a  journey  of 
fome  length,  and  Briftol  being,  as  is  ufual  in  fuch  cafes,  recom- 
mended, he  fet  out  on  the  i9th  of  April,  and  arrived  thereon 
the  2d  of  May.  During  the  greater  part  of  this  journey  (of 
175  miles)  his  cough  was  fevere,  and  being  obliged  to  be  bled 
three  different  times  on  the  road,  he  was  no  longer  able  to  fit  up- 

right, 


25*  DISEASES  CLASS  II.  i.  6. 7. 

right,  but  at  very  fhort  intervals,  and  was  obliged  to  lie  at  length 
in  the  diagonal  of  a  coach.  The  hectic  paroxyfms  were  not  in- 
terrupted during  the  journey,  but  they  were  irregular  and  indif-* 
tinct,  and  the  falutary  effects  of  exercife,  or  rather  of  geftation, 
were  imprefled  on  the  patient's  mind. 

At  Briftol  he  flayed  a  month,  but  reaped  no  benefit.  The 
weather  was  dry  and  the  roads  dufty  ;  the  water  infipid  and  in- 
ert. He  attempted  to  ride  on  horfeback  on  the  downs,  but  was 
not  able  to  bear  the  fatigue  for  a  diftance  of  more  than  a  hundred 
yards.  The  neceffity  of  frequent  bleedings  kept  down  his 
ftrength,  and  his  hectic  paroxyfms  continued,  though  lefs  fe- 
vere.  At  this  time,  fufpecting  that  his  cough  was  irritated  by 
the  weft  winds  bearing  the  vapour  from  the  fea,  he  refolved 
to  try  the  effects  of  an  inland  fituation,  and  fet  off  for  Matlock 
in  Derby(hire. 

During  the  journey  he  did  not  find  the  improvement  he  ex- 
pected, but  the  nightly  perfpirations  began  to  diminifh ;  and 
the  extraordinary  fatigue  he  experienced  proceeded  evidently 
from  his  travelling  in  a  poft-chaiie,  where  he  could  not  indulge 
in  a  recumbent  pofition.  The  weather  at  Briftol  had  been  hot, 
and  the  earth  arid  and  dufty.  At  Matlock,  during  the  month 
of  June  1784,  there  was  almoft  a  perpetual  drizzle,  the  foil  was 
wet,  and  the  air  moift  and  cold.  Here,  however,  the  patient's 
cough  began  to  abate,  and  at  intervals  he  found  an  opportunity 
of  riding  more  or  lefs  on  horfeback.  From  two  to  three  hundred 
yards  at  a  time,  he  got  to  ride  a  mile  without  flopping  ;  and  at 
length  he  was  able  to  fit  on  horfeback  during  a  ride  from  Mafan's 
Bath  to  the  village  of  Matlock  along  the  Derwent,  and  round 
on  the  oppofite  banks,  by  the  works  of  Mr.  Arkwright,  back  to 
the  houfe  whence  he  darted,  a  diftance  of  five  miles.  On  dif- 
mounting,  however,  he  was  feized  with  diliquium,  and  foon  after 
the  ftrength  he  had  recovered  was  loft  by  an  attack  of  the  haem- 
orrhoids of  the  mod  painful  kind,  and  requiring  much  lofs  of 
blood  from  the  parts  affected. 

On  reflection,  it  appeared  that  the  only  benefit  received  by 
the  patient  was  during  motion,  and  continued  motion  could  bet- 
ter be  obtained  in  the  courfe  of  a  journey  than  during  his  refi- 
dence  at  any  particular  place.  This,  and  other  circumftances  of 
a  private  but  painful  nature,  determined  him  to  fet  out  from 
Matlock  on  a  journey  to  Scotland.  The  weather  was  now  much 
improved,  and  during  the  journey  he  recruited  his  ftrength. 
Though  as  yet  he  could  not  fit  upright  ?,t  reft  for  half  an  hour 
together  without  a  difpofition  to  giddinefs,  dimnefs  of  fight,  and 
diliquium,  he  was  able  to  fit  upright  under  the  motion  of  a  poft- 
during  a  journey  of  from  40  to  70  miles  daily,  and  his 

appetite 


Clafs  II.  i.  6.  7.         OF  SENSATION.  253 

appetite  began  to  improve.  Still  his  cough  continued,  and  his 
hectic  flumings,  though  the  chills  were  much  abated  and  very 
irregular. 

The  falutary  effects  of  motion  being  now  more  ftriking  than 
ever,  he  purchafed  a  horfe  admirably  adapted  to  a  valetudinarian 
in  Dumfriesfhire,  and  being  now  able  to  fit  on  horfeback  for  an 
hour  together,  he  rode  out  feveral  times  a  day.  He  fixed  his 
refidence  for  a  few  weeks  at  Moffat,  a  village  at  the  foot  of  the 
mountains  whence  the  Tweed,  the  Clyde,  and  the  Annan,  de- 
fcend  in  different  directions  ;  a  fituation  inland,  dry,  and  healthy, 
and  elevated  about  three  hundred  feet  above  the  furface  of  the 
fea.  Here  his  ftrength  recovered  daily,  and  he  began  to  eat  an- 
imal food,  which  for  feveral  months  before  he  had  not  tafted. 
Perfevering  in  exercife  on  horfeback,  he  gradually  increafed  the 
length  of  his  rides,  according  to  his  ftrength,  from  four  to  twenty 
miles  a  day  ;  and  returning  on  horfeback  to  Lancafhire  by  the 
lakes  of  Cumberland,  he  arrived  at  Liverpool  on  the  firft  of  Sep- 
tember, having  rode  the  laft  day  of  his  journey  forty  miles. 

The  two  inferences  of  moft  importance  to  be  drawn  from  this 
narrative,  are,  firft,  the  extraordinary  benefit  derived  from  gefta- 
tion  in  a  carriage,  and  ftill  more  the  mixture  of  geftation  and 
exercife  on  horfeback,  in  arrefting  or  mitigating  the  hectic  par- 
oxyfm  -,  and  fecondiy,  that  in  the  florid  confumption,  as  Dr. 
Beddoes  terms  it,  an  elevated  and  inland  air  is  in  certain  circum- 
ftances  peculiarly  falutary ;  while  an  atmofphere  loaded  with 
the  fpray  of  the  fea  is  irritating  and  noxious.  The  vicinity  of 
the  fea  appears  very  injurious  to  almoft  all  vegetables,  and  fliould 
on  that  account  be  fufpected  in  refpect  to  its  general  falubrity, 
though  it  may  neverthelefs  be  medicinal  in  fome  difeafes,  if  re- 
forted  to  for  a  time  in  the  fummer  months,  but  muft  be  ineligible 
as  a  permanent  refidence.  See  Clafs  I.  2.  i.  15. 

The  benefit  derived  in  this  cafe  from  exercife  on  horfeback, 
may  lead  us  to  doubt  whether  Sydenham's  praiie  of  this  remedy 
be  as  much  exaggerated  as  it  has  of  late  been  iuppofed.  Since  the 
publication  of  Dr.  C.  Smyth  on  the  effects  of  fwinging  in  low- 
ering the  pulfe  in  the  hectic  paroxyfm,  the  fubject  of  this  nar- 
rative has  repeated  his  experiments  in  a  great  variety  of  cafes, 
and  has  confirmed  them.  He  has  alfo  repeatedly  feen  the  hectic 
paroxyfm  prevented,  or  cut  ihort,  by  external  ablution  of  the 
naked  body  with  tepid  water. 

So  much  was  his  power  of  digeftion  impaired  or  vitiated  by 
the  immenfe  evaucations,  and  the  long  continued  debility  he  un- 
derwent, that  after  the  cough  was  removed,  and  indeed  for  fev- 
eral years  after  the  period  mentioned,  he  never  could  eat  animal 
food  without  heat  and  flufhing,  with  frequent  pulfe  and  extreme 

drowfinefs. 


254  DISEASES  Clafs  II.  i.  6.  7. 

drowfinefs.  If  this  drowfinefs  was  encouraged,  the  fever  ran 
high,  and  he  awoke  from  difturbed  fleep,  wearied  and  deprefled. 
If  it  was  refolutely  refitted  by  gentle  exercife,  it  went  off  iir about 
an  hour,  as  well  as  the  increafed  frequency  of  the  pulfe.  This 
agitation  was  however  fuch  as  to  incapacitate  him  during  the 
afternoon  for  ftudy  of  any  kind.  The  fame  effects  did  not  fol- 
low a  meal  of  milk  and  vegetables,  but  under  this  diet"his  ftrength 
did  not  recruit  ;  whereas  after  the  ufe  of  animal  food  it  recov- 
ered rapidly,  not  with  (landing  the  inconvenience  already  men- 
tioned. For  this  inconvenience  he  at  laft  found  a  remedy  in  the 
ufe  of  coffee  immediately  after  dinner,  recommended  to  him  by 
his  friend  Dr.  Percival.  At  firft  this  remedy  operated  like  a 
charm,  but  by  frequent  ufe,  and  indeed  by  abufe,  it  no  longer 
pofieiTes  its  original  efficacy. 

Dr.  Falconer,  in  his  Differtation  on  the  Influence  of  the  Paf- 
fions  and  Affections  of  the  Mind  on  Health  and  Difeafe,  fuppo- 
fes  that  the  cheerfulnefs  which  attends  hectic  fever,  the  ever- 
fpringing  hope,  which  brightens  the  gloom  of  the  confumptive 
patient,  increafes  the  difeafed  actions,  and  haftens  his  doom. 
And  hence  he  is  led  to  inquire,  whether  the  influence  of  fear 
might  not  be  fubflituted  in  fuch  cafes  to  that  of  hope  with  ad- 
vantage  to  the  patient  ?  This  queftion  I  fhall  not  prefume  to 
anfwer,  but  it  leads  me  to  fay  fomething  of  the  ftate  of  the  mind 
in  the  cafe  juft  related. 

The  patient,  being  a  phyfician,  was  not  ignorant  of  his  dan- 
ger, which  forne  melancholy  circumftances  ferved  to  imprefs 
on  his  mind.  It  has  already  been  mentioned,  that  his  mother 
and  grandfather  died  of  this  difcafe.  It  may  be  added,  that  in 
the  year  preceding  that  on  which  he  himfelf  was  attacked,  a 
fifter  of  his  was  carried  oi?  by  confumption  in  her  i  yth  year  ; 
that  in  the  fame  winter  in  which  he  fell  ill,  two  other  lifters 
were  feized  with  the  fame  fatal  diforder,  to  which  one  of  them 
fell  a  victim  during  his  refidence  at  Briftol,  and  that  the  hope 
of  bidding  a  laft  adieu  to  the  other  was  the  immediate  caufe  of 
his  journey  to  Scotland,  a  hope  which,  alas  !  was  indulged  in 
vain.  The  day  on  which  he  reached  the  end  of  his  journey,  her 
remains  were  committed  to  the  duft  I  It  may  be"  conjectured 
from  thefe  circumitances,  that  whatever  benefit  may  be  derived 
from  the  apprehenfion  of  death,  muft  in  this  cafe  have  been 
obtained.  The  expectation  of  this  ifTue  was  indeed  for  fome 
time  fo  fixed  that  it  ceafed  to  produce  much  agitation  5  in  con- 
formity to  that  general  law  of  our  nature,  by  which  aim  oft  all 
men  fubmit  with  compofure  to  a  fate  that  is  forefeen,  and  that 
appears  inevitable.  As  however  the  progrefs  of  difeaie  and  de- 
bility feemed  to  be  arreited,  the  hope  and  the  love  of  life  reviv- 
ed, 


CLASS  II.  i.  6.  3.  OF  SENSATION.  255 

ed,  and  produced,  from  time  to  time,  the  obfervations  and  the 
exertions  already  mentioned. 

Wine  and  beer  were  rigoroufiy  abftained  from  during  fix 
months  of  the  above  hiftory  ;  and  all  the  blood,  whicfc  was  ta- 
ken, was  even  to  the  laft  buffy.  Feb.  3,  1795. 

It  has  lately  been  aflerted,  that  the  people  of  Holland  are  lefs 
liable  to  confumption  of  the  lungs,  than  thofe  of  many  other 
parts  of  Europe,  which  has  been  aicribed  to  their  warmer  cloth- 
ing. I  am  aware  of  the  difficulty  of  making  fuch  eilimates  with 
any  great  degree  of  certainty,  but  if  fuch  be  the  fact,  it  may  in- 
deed be  afcribed  with  fome  degree  of  probability  to  their  ufing 
very  warm  clothing,  but  not  very  warm  rooms  during  the  winter 
feafon.  Whence  the  lungs  are  not  fo  much  expofed  to  the 
great  and  fudden  tranfition  from  very  warm  rooms  into  frofty 
air,  as  in  this  country.  And  though  the  lungs  have  not  a  fen- 
fation  of  cold  or  of  chilneis  like  the  external  Ikin,  in  pafiing  from 
very  warm  air  into  great  cold,  often  much  below  the  freezing 
point,  yet  they  are  liable  to  inflammation,  like  other  parts  of  the 
fyftem.  But  to  this  may  be  objected,  that  the  hereditary  pul- 
monary confumption  attacks  the  patient  fo  infallibly  a  few  years 
after  puberty,  that  it  does  not  appear  to  depend  much  on  exter. 
nal  circumftances. 

8.  Febrisfcrofuloja.     The  hectic  fever  occafioned  by  ulcers  of 
the  lymphatic  glands,  when  expofed  to  the  air,  does  not  differ 
from  that  attending  pulmonary  confumption,  being  accompanied 
with  night-fweats  and  occafional  diarrhoea. 

M.  M.  The  bark.  Opium  internally.  Externally  cerufla 
and  bark  in  fine  powder.  Bandage.  Sea-bathing.  See  Clafs 
I.  2.  3.  21.  and  II.  i.  4.  12. 

9.  Felris  ifchiadica.     A  hectic  fever  from  an  open  ulcer  be- 
tween the  mufcles  of  the  pelvis,  which  differs  not  from  the  pre- 
ceding.    If  the  matter  in  this  fituation  lodges  till  part  of  it,  I  fup- 
pofe,  becomes  putrid,  and    aerates  the  other  part  ;  or  till  it  be- 
comes abforbed  from  fome  other  circum fiance  j  a  fimilar  hectic 
fever  is  produced,  with  night-fweats,  or  diarrhoea. 

Mrs.  ,  after  a  lying  in,  had  pain  on  one  fide  of  her  loins, 

which  extended  to  the  internal  part  of  the  thigh  on  the  fame 
fide.  No  fluctuation  of  matter  could  be  felt ;  fhe  became  hec- 
tic with  copious  ntght-fweats,  and  occafional  diarrhoea,  for  four 
or  five  weeks  ;  and  recovered  by,  I  iuppofe,  the  total  abforption 
of  the  matter,  and  the  reunion  of  the  walls  of  the  abfcefs.  See 
Clafs  II.  i.  2.  18. 

10.  Febris  Arthropucdica.     Fever  from  the  matter  of  difeafed 
joints.     Does  the  matter  from  fuppurating  bones,  which  gener- 
ally 


DISEASES  CLASS  II.  i.  6,  if- 

ally  has  a  very  putrid  fmell,  produce  heftic  fever  or  typhus  ?  See 
ClafsII.  1.4.  1 6. 

1 1 .  Febris  a  pure  contagiofo.     Fever   from  contagious   pus. 
When  the  contagious  matters  have  been  produced  on  the  exter- 
nal habit,  and  in   procefs  of  time  become   abforbed,  a  fever  is 
produced  in   confequence  of  this  reabforption  j    which  differs 
with  the  previous  irritability  or  inirritability,  as  well  as  with  the 
fenfibility  of  the  patient. 

1 2.  Febris  variolofa  fecundaria.     Secondary  fever  of  fmall-pox. 
In  the  diftincl:  fmall-pox  the  fever  is  of  the  fenfitive  irritated  or 
inflammatory  kind  ;  in  the  confluent  fmall-pox  it  is  of  the  fenfi- 
tive inirritated  kind,  or  typhus  gravior.     In  both   of  them   the 
fweliing  of  the  face,  when  the  matter  there  begins  to  be  abforb- 
ed, and  of  the  hands,  when   the  matter  there  begins  to  be  ab- 
forbed, ftiew,  that  it   ftimulates  the  capillary  vefTels  or  glands, 
occafioning  an  increafed  fecretion  greater  than  the  abforbents 
can  take  up,  like  the  aclion  of  the  camharides  in  a  blifter  ;  now 
as  the  application  of  a  blifter   on  the  fkin  frequently  occafions 
the  ftrangury,  which  mews,  that  fome  part  of  the  cantharides  is 
abforbed  ;  there  is  reafon  to  conclude,  that  a  part  of  the  matter 
of  fmall-pox  is  abforbed,  and  thus  produces  the  fecondary  fever. 
See  Clafs  II.  1.3.9.       And  not  ^mply  by  its  ftimulus  on  the 
furface  of  the  ulcers  beneath  the  fcabs.     The  exfudation  of  a 
yellow  fluid  from  beneath  the  confluent  eruptions   on  the  face 
before  the  height  is  fpoken  of  in  Clafs  II.  I.  3.  2. 

The  material  thus  abforbed  in  the  fecondary  fever  of  fmall- 
pox  differs  from  that  of  open  ulcers,  as  it  is  only  aerated  through 
the  elevated  cuticle  ;  and  fecondly,  becaufe  there  is  not  a  con- 
flant  fupply  of  frefh  matter,  when  that  already  in  the  puftules 
is  exhaufted,  either  by  abforption,  or  by  evaporation,  or  by  its 
induration  into  a  fcab.  Might  not  the  covering  the  face  af- 
fiduoufly  and  exactly  with  plafters,  as  with  cerate  of  calamy,  or 
with  minium  plafter,  by  precluding  the  air  from  the  puftules, 
prevent  their  contracting  a  contagious,  or  acefcent,  or  fever-pro- 
ducing power  ?  and  the  fecondary  fever  be  thus  prevented  entirely. 
If  the  matter  in  thofe  puftules  on  the  face  in  the  confluent  fmall- 
pox  were  thus  prevented  from  oxygenation,  it  is  highly  proba- 
ble, both  from  this  theory,  and  from  the  facts  before  mentioned, 
that  the  matter  would  not  erode  the  fkin  beneath  them,  and  by 
thefe  means  no  marks  or  fears  would  fucceed. 

13.  Febris  carcinomatofa.     Fever  from  the  matter  of  cancer. 
In  a  late  publication  the  pain  is  faid  to.be  relieved,  and    the  fe- 
ver cured,  and  the  cancer  eradicated,  by  the   application  of  car- 
bonic acid  gas,  or  fixed  air.     See  Clafs  II.  i.  4.  16. 

14.  Febris 


CLASS  tt.  i.  &  14.        OF  SENSATION. 

14.  Felrts  wnerea.     From  the  abforption  of  the  matte*  from 
Venereal  ulcers  and  fuppurating  bones.  See  Syphilis,  II.  i.  5.  2. 

M.  M.  Any  mercurial  calx.     Sarfaparilla  ?  Mezereon  ? 

15.  Febris  a  fame  putrida*     Fever  from  putrid  fanies.  When 
parts  of  the  body  are  deitroyed  by  external  violence,  as  a  bruife, 
or  by  mortification,  a  putrefaction  foon  fucceeds  j  as   they  are 
kept  in  that  degree  of  warmth  and  moiilure,  by  their  adhefioli 
to  the  living  parts  of  the  body,  which  moil  forwards  that  proc* 
efs.     Thus  the  floughs  of  mortified  parts  of  the  tonfils  give  fe- 
tor to  the  breath   in  fome  fevers ;  the  matter  from  putrefying 
teeth,  or  other  fuppurating  bones,  is  particularly  offenfive  j  and 
even  the  fcurf,  which  adheres  to  the  tongue,  frequently  acquires 
a  bitter  tafte  from  its  incipient  putridity*     This  material  differs 
from  thofe  before  mentioned,  as  its  deleterious  property  depends 
on  a  chemical  rather  than  an  animal  procefs. 

1 6.  fiebris  puerpera.    Puerperal  fever.     It  appears  from  fome 
late  diflections,  which  have  been  publifhed,  of  thofe  women  who 
have  died  of  the  puerperal  fever,  that  matter  has  been  formed  in 
the  omentum,   and  found  in  the  cavity  of  the  abdomen,  with 
fome  blood  or  fanies.     Thefe  parts   are  fuppofed  to  have  beeri 
injured  by  the  exertions  accompanying  labour ;  and  as  matter  in 
this  vifcus  may  have  been  produced  without  much   pain,  this 
difeafe  is  not  attended  with  arterial  ftrength  and  hard  full  pulfe, 
like  the  inflammation  of  the  uterus ;   and  as  the  fever  is  of  the 
inirritative  or  typhus  kind,  there  is  reafon  to  believe,  that  the 
previous  exhauftion  of  the  patient  during  labour  may  contribute 
to  its  production  ;  as  well  as  the  abforption  of  a  material  not 
purulent  but  putrid  j  which  is  formed  by  the  delay  of  extrava- 
fated  or  dead  matter  produced  by  the  bruifes  of  the  omentum, 
or  other  viicera,  in  the  efforts  of  parturition,  rather  than  by  pur- 
ulent matter,  the  confequence  ot  fuppu ration*     The  pulfe  i$ 
generally  about   1 20  when  in  bed,  and  in  the  morning  ;  and  is 
increafed  to  134,  or  more,  when  the  patient   fits  up,  or  in  the 
evening  paroxyfm.     The  pulfe  of  all  very  weak  patients  incrcai- 
es  in  frequency  when  they  fit   up  ;  becaufe  the  expenditure  ol 
fenforial  power  neceflfary  to  preferve  a»  erect  polture  deducts  fo 
much  from  their  general  ftrefigth  ;  and  hence  the  pulfe  becomes 
weaker* and  in  confequence  quicker.     See  Sect.  XII.  i.  4. 

Whence  I  fufpect  that  the  puerperal  fever  is  diftinguiilted 
from  the  hectic  fever,  by  the  former  being  produced   and  fup- 
ported  by  the  abforption  of  a  putrid   fanies,  aiifing  from  dead 
parts  of  the  omentum  or  rnefentery ;  and  the  latter  being  pro- 
duced and   fupported   by   the   abforption  of  purulent  nutter, 
which  is  the  confequcncc.'  of  inflammation,  after  it  h::s  b6en  ox- 
ited  l?y  expofure  to  ihc-  air;  and   rlru  hau';    they  differ  in 
"Voj..  \\  the 


25 8  DISEASES  CLASS  II.  i.  6.  16. 

the  greater  debility,  and  confequent  quicker  pulfe,  and  more 
rapid  progrefs  of  the  former  than  the  latter ;  but  agree,  in  the 
few  patients  which  I  have  attended,  in  the  circumitance  of  the 
patients  bearing  the  quantity  of  thefe  fevers  better  than  the 
typhus,  as  i;;  feen  in  their  frequent  rifing  from  their  beds  for 
hours,  and  even  attending  to  their  occupations  with  a  pulfe  of 
more  than  120  in  a  minute  ;  and  alfo  in  another  important  cir- 
cum (lance,  which  is,  that  they  take  folid  food,  as  bread,  and 
eggs,  and  oytlers,  and  even  chicken,  in  great  quantities  ;  which 
in  the  inirritative  fever,  or  typhus,  is  refufed  during  the  whole 
courfe  of  the  difeafe.  And  hence  it  feems  probable,  that  the 
caufe  or  comrrencement  of  the  inirritative  fever,  or  typhus,  may 
have  been  from  the  torpor  or  paralyfis  of  the  ftomach,  owing  to 
the  fwallowing  of  contagious  matter  along  with  our  faliva  ;  and 
the  actions  of  the  heart  fuffer  in  confequence  from  fympathy. 
And  that  hence  thefe  three  kinds  of  fever  may  be  diftinguimed 
from  each  other :  the  typhus,  by  the  total  lofs  of  appetite  for 
folid  food  ;  the  heftic  fever,  by  the  pulfe  being  feldom  above 
1 20,  and  with  attendant  inflammation  ;  and  the  puerperal  fever, 
by  a  quicker  and  weaker  pulfe  ;  but  both  the  latter  exifting 
without  the  inability  to  take  fome  folid  nourifhment. 

In  this  fever  time  muit  be  allowed  for  the  abforption  of  the 
matter.  Very  large  and  repeated  quantities  of  the  bark,  by 
preventing  fufficient  food  from  being  taken,  as  bread,  and  wine, 
and  water,  I  have  thought,  have  much  injured  the  patient ;  for 
the  bark  is  not  here  given,  as  in  intermittent  fevers,  to  prevent 
the  paroxyfro,  but  (imply  to  ftrengthen  the  patient  by  increafing 
the  power  of  digeflion.  About  two  ounces  of  decoction  of 
bark,  with  four  drops  of  laudanum,  and  a  drachm  of  fwect  fpir- 
it  of  vitriol,  once  in  fix  hours,  and  a  glafs  of  wine  between  thofe 
times,  with  panada,  or  other  food,  I  have  thought  of  mod  ad- 
vantage, with  a  fmall  blifter  occafionally. 

Where  not  only  the  ftomach  but  alfo  the  bowels  are  much 
diftended  with  air,  fo  as  to  found  on  ftriking  them  with  the  fin- 
gers, the  cafe  is  always  dangerous,  generally  hopelefs  ;  which 
is  more  fo  in  proportion  to  the  quicknefs  of  the  pulfe.  Where 
the  bowels  are  diftended  two  drops  of  oil  of  cinnamon  piould 
be  given  in  the  panada  three  or  four  times  a  day,  with  ten  grains 
of  alum. 

In  one  cafe  of  puerperal  fever,  which  lafted  above  forty  days, 
and  was  attended  for  the  laft  fortnight  with  perpetual  fubfultus 
of  the  tendons,  and  even  twitching  of  the  hands  with  unceafing 
delirium,  and  inability  to  fleep,  mufk  given  in  the  dofe  of  ten 
grains  every  fix  hours,  with  five  drops  of  tincture  of  opium, 
teemed  to  be  of  fervice  \  and  when  the  abdomen  became  tumid 

with 


CLASS  II.  i.  6.  16.         OF  SENSATION.  259 

with  air,  about  the  36th  day  from  the  commencement  of  the 
fever,  alum  given  in  dofes  of  about  feven  grains  every  three 
hours,  Deemed  of  uncommon  fervice,  as  the  tumour  of  the  abdo- 
men much  fubfided  in  one  day,  and  the  patient  immediately  be- 
came able  to  fleep  two  or  three  hours  at  a  time ;  but  the  event 
of  the  difeafe  was  fatal. 

In  this  fituation  I  fuppofe  the  fever  to  have  been  kept  up  by 
the  abforption  of  a  putrid  material  in  the  abdomen,  on  the 
outfide  of  the  inteftines  ;  and  as  alum  inftantaneoufly  deitroys 
the  volatile  alkali  which  occafions  a  part  of  the  fmell,  and  per- 
haps the  whole  of  the  gas  of  putrid  matter ;  which  alkali  pre- 
cipitates the  argillaceous  earth  from  the  vitriolic  acid  ;  I  iup- 
pofe  this  effect  would  be  produced  by  alum, .  though  it  might 
not  be  produced  by  vitriolic  acid,  as  the  latter  would  unite  witli 
the  contents  of  the  ftomach  ;  but  the  alum  would  not  unite 
with  any  thing,  till  it  became  expofed  to  exhalations  of  putrid 
matter.  See  Clafs  II.  I.  3.  i.  Might  not  a  puncture  by  a  lan- 
cet into  the  tumid  abdomen,  through  the  fear  of  the  navel,  be 
of  ufe,  when  it  is  much  diftended  with  air  ? 

The  want  of  fleep  was  owing  to  debility,  and  ceafed  when 
that  became  leflened.  As  fome  motions  of  the  hands  were  the 
confequence  of  her  delirious  ideas,  thefe  became  tremulous,  like 
the  hands  of  very  old  men,  or  drunkards,  from  debility  whenev- 
er they  were  exerted. 

A  very  interefting  account  of  the  puerperal  fever,  which  was 
epidemic  at  Aberdeen,  has  been  lately  published  by  Dr.  Alexan- 
der Gordon.  (Robinfons,  London.)  In  feveral  directions  of 
thofc  who  died  of  this  difeafe,  purulent  matter  was  found  in  the 
cavity  of  the  abdomen ;  which  he  afcribes  to  an  eryfipelatous 
inflammation  of  the  peritonseum,  as  its  principal  feat,  and  of  its 
productions,  as  the  omentum,  mefentery,  and  peritonaea!  coat 
of  the  inteftines. 

He  believes,  that  it  was  infectious,  and  that  the  contagion 
was  always  carried  by  the  accoucheur,  or  the  nurfe,  from  one  ly- 
ing-in woman  to  another. 

The  difeafe  began  with  violent  unremitting  pain  of  the  abdo- 
men on  the  day  of  delivery,  or  the  next  day,  with  fhuddering, 
and  very  quick  pulfe,  often  140  in  a  minute.  In  this  fituation, 
if  he  faw  the  patient  within  12  or  24  hours  of  her  feizure,  he 
took  away  from  j6  to  24  ounces  of  blood,  which  was  always 
fizy.  He  then  immediately  gave  a  cathartic,  confiding  of  three 
grains  of  calomel,  and  forty  grains  of  powder  of  jalap.  After 
this  had  operated,  he  gave  an  opiate  at  night ;  and  continued 
the  purging  and  the  opiate  for  federal  days. 

He  aliens,  that  almoft  all  thofe,  whom  he  was   permitted  to 


DISEASES  CLASS  II.  i.  6.  i& 

treat  in  this  manner  early  in  the  difeafe,  recovered,  to  the  num- 
ber of  50  ;  and  that  almoft  all  the  reft  died.  But  that  when 
two  or  three  days  were  elapfed,  the  patient  became  too  weak 
for  this  method  j  and  the  matter  was  already  formed,  which  de* 
ftroyed  them.  Except  that  he  faw  two  patients  who  recovered, 
after  difcharging  a  large  quantity  of  matter  at  the  navel.  And 
p.  few  who  were  relieved,  by  the  appearance  of  external  eryfipe- 
Jas  on  the  extremities. 

This  difeafe,  confiding  of  an  eryflpelatous  inflammation,  may 
occafion  the  great  debility  fooner  to  occur  than  in  inflammation 
of  the  uterus  $  which  latter  is  neither  eryfipelatous,  I  fuppofe, 
nor  contagious.  And  the  fuccefs  of  Dr.  Gordon's  practice 
feems  to  correfpond  with  that  of  Dr.  Rufh,  in  the  contagious 
fever  or  plague  at  Philadelphia ;  which  appeared  to  be  much  ak 
fifted  by  early  evacuations.  One  cafe  I  faw,  fome  time  ago, 
where  violent  unceafmg  pain  of  the  whole  abdomen  occurred,  a 
few  hours  after  delivery,  with  quick  pulfe  j  which  ceafed  after 
the  patient  had  twice  loft  about  eight  ouncqs  qf  blood,  and  had 
taken  a  moderate  cathartic  with  calomel. 

This  cafe  induces  me  to  think,  that  it  might  be  fafer,  and 
equally  efficacious,  to  take  lefs  blood  at  firft  than  Dr.  Gordon 
mentions,  and  to  repeat  the  operation  in  a  few  hours,  if  the 
continuance  of  the  fymptoms  fhould  require  it.  And  the  fame 
in  refpedl  to  the  cathartic,  which  might  perhaps  be  given  in  lefs 
quantity,  qnd  repeated  every  two  or  three  hours. 

Nor  ihould  I  wifti  to  give  an  opiate  after  the  firft  venefecHon 
and  cathartic  ;  as!  fufpecl:  that  this  might  be  injurious,  except 
thofe  evacuations  had  emptied  the  veflels  fo  much,  that  the  ftim-* 
ulus  of  the  opiate  fhould  acl:  only  by  increafmg  the  abforption 
of  the  new  veflels  or  fluids  produced  on  the  furfacesof  the  infla- 
med membranes.  In  other  inflammations  of  the  bowels,  and 
in  acute  rheumatifm,  I  have  feen  the  difeafe  much  prolonged, 
and  I  believe  fometimes  rendered  fatal,  by  the  too  early  adminik 
tration  of  opiates,  either  along  with  cathartics,  or  at  their  inter-* 
vals  *,  while  a  fmall  dofe  of  opium  given  after  fufficient  evacua« 
tions  produces  abforption  only  by  its  ftimulus,  and  much  can-? 
tributes  to  the  cure  of  the  patient.  We  may  have  vifible  teftif 
mony  of  this  efFecl:  of  opium,  when  a  folution  of  it  is  put  into 
an  inflamed  eye  ;  if  it  be  thus  ufed  previous  to1  fufficient  evacun-* 
tion,  it  increafes  the  inflammation ;  if  it  be  ufed  after  fufHcient 
evacuation,  it  increafes  abforption  only,  and  clears  the  eye  in  a 
very  fmall  time. 

I  cannot  omit  cbferving,  from  confidering  thefe  circumftances, 
Jicw  unwife  is  the  common  practice  of  giving  an,  opiate  to  every 
*  woman. 


CLASS  II,  1.6,  17.      OF  SENSATION-  261 

woman  immediately  after  her  delivery,  which  muft  often  have 
been  of  dangerous  confequence, 

17.  Febris  a  fphaceh.  Fever  from  mortification.  This  fever 
from  abforption  of  putrid  matter  is  of  the  inirritative  or  typhus 
kind.  See  the  preceding  article. 

M.  M.  Opium  and  the  bark  are  frequently  given  in  too 
great  quantity,  fo  as  to  induce  confecjuent  debility,  and  to  oppref* 
the  power  of  digeftion, 


OUDO 


262  DISEASES  CLASS  IT.  i.  7.  i. 

ORDO    I. 

Increafed  Senfation. 
GENUS  VII. 

With  increafed  Aftion  of  the  Organs  ofSenfe. 
SPECIES. 

I.  Delirium  febrile.  Paraphrofyne.  The  ideas  in  delirium 
confift  of  thofe  excited  by  the  fenfation  of  pleafure  or  pain, 
which  precedes  them,  and  the  trains  of  other  ideas  aflbciated 
with  thefe  and  not  of  thofe  excited  by  external  irritations  or  by 
voluntary  exertion.  Hence  the  patients  do  not  know  the  room 
which  they  inhabit,  or  the  people  who  furround  them ;  nor  have 
they  any  voluntary  exertion,  where  the  delirium  is  complete  ;  fo 
that  their  efforts  in  walking  about  a  room  or  rifing  from  their 
bed  are  unfteady,  and  produced  by  their  catenations  with  the  im- 
mediate affections  of  pleafure  or  pain.  See  Section  XXXIII.  i.  4. 

By  the  above  circumftances  it  is  diftinguimed  from  madnefs, 
in  which  the  patients  well  know  the  perfons  of  their  acquaint- 
ance, and  the  place  where  they  are  ;  and  perform  all  the  volun- 
tary actions  with  fteadinefs  and  determination.  See  Seel:. 
XXXIV.  2.  2. 

Delirium  is  fometimes  lefs  complete,  and  then  a  new  face 
and  louder  voice  ftimulate  the  patient  to  attend  to  them  for  a 
few  moments  ;  and  then  they  relapfe  again  into  perfect  delirium. 
At  other  times  a  delirium  affects  but  one  fenfe,  and  the  perfon 
thinks  he  fees  things  which  do  not  exift  ;  and  is  at  the  fame 
time  fenfible  to  the  queftions  iwhich  are  alked  him,  and  to  the 
tafte  of  the  food  which  is  offered  to  him. 

This  partial  delirium  is  termed  a  hallucination  of  the  difor- 
dered  organ;  and  may  probably  arife  from  the  origin  of  one 
nerve  of  fenfe  being  more  liable  to  inflammation  than  the  others  ; 
that  is,  an  exuberance  of  the  fenforial  power  of  fenfation  may  af- 
fect it ;  which  is  therefore  thrown  into  action  by  {lighter  fenfi- 
tive  catenations,  without  being  obedient  to  external  ftimulus,  or 
to  the  power  of  volition. 

The  perpetual  flow  of  ideas  in  delirium  is  owing  to  the  fame 
circumttance,  as  of  thofe  in  our  dreams ;  namely,  to  the  defect 
or  paralyfis  of  the  voluntary  power  5  as  in  hemiplegia,  when  one 
fide  of  the  body  is  paralytic, and  thus  expends  lefs  of  the  fenforial 
power,  the  limbs  on  the  other  fide  are  in  conltant  motion  from 

the 


Clafs  II.  i.  7.  2.         OF  SENSATION.  263 

the  exuberance  of  it.  Whence  lefs  fenforial  power  is  exhaufted 
in  delirium,  than  at  other  times,  as  well  as  in  fleep  ;  and  hence  in 
fevers  with  great  debility,  it  is  perhaps,  as  well  as  the  ftupor, 
rather  a  favourable  circumftance  ;  and  when  removed  by  numer- 
ous blifters,  the  death  of  the  patient  often  follows  the  recovery 
of  his  underftanding.  See  Clafs  I.  2.  5.  6.  and  I.  2.  5.  10. 

Delirium  in  difeafes  from  inirritability  is  fometimes  preceded 
by  a  propenfity  to  furprife.  See  Clafs  I.  I.  5.  12. 

M.  M.  Fomentations  of  the  fhaved  head  for  an  hour  repeat- 
edly. A  blifter  on  the  head.  Rifing  from  bed.  Wine  and 
opium,  and  fometimes  venefeclion  in  fmall  quantity  by  cupping, 
if  the  ftrength  of  the  arterial  fyftem  will  allow  it. 

2.  Delirium  maniacale.    Maniacal  delirium.     There  is  anoth- 
er kind  of  delirium,  defcribed  in  Se&.  XXXIII.  i.  4.  which  has 
the  increafe  of  pleafurable  or  painful  fenfation  for  its  caufe, 
without  any  diminution  of  the  other  fenforial  powers  ;  but  as 
this  excites  the  patient  to  the  exertion  of  voluntary  actions,  for 
the  purpofe  of  obtaining  the  object  of  his  pleafurable  ideas,  or 
avoiding  the  object  of  his  painful  ones,  fuch  as  perpetual  prayer, 
when  it  is  of  the  religious  kind  ;  it  belongs  to  the  infanities  de- 
fcribed in  Clafs  III.   i.  2.   i.  and  is  more  properly  termed  hal- 
lucinatio  maniacalis. 

3.  Delirium  ebrietatis.     The  drunken  delirium  is  in  nothing 
different  from  the  delirium  attending  fevers  except  in  its  caufe, 
as  from  alcohol,  or  other  poifons.     When  it  is  attended  with  an 
apoplectic  ftupor,  the  pulfe  is  generally  low ;  and  venefection 
I  believe  fometimes  deftroys  thofe,  who  would  etherwite  have 
recovered  in  a  few  hours. 

M.  M.  Diluting  liquids.     An  emetic. 

4.  Somnium.     Dreams  conftitute  the  mod  complete  kind  of 
delirium.     As  in  thefe  no  external  irritations  are  attended  to, 
and  the  power  of  volition  is  entirely  fufpended  ;  fo  that  the 
fenfations  of  pleafure  and  pain,  with  their  aflbciations,  alone  ex- 
cite the  endlefs  trains  of  our  fleeping  ideas  j  as  explained*  in 
Sea.  XVIII.  on  fleep. 

5.  Hallucinatio  vifus.     Deception  of  fight.     Thefe  vifual  hal- 
lucinations are  perpetual  in  our  dreams  ;  and  fometimes  pre- 
cede general  delirium  in  fevers  ;  and  fometimes  belong  to  rev- 
erie, and  to  infinity.    See  Clafs  III.  i.  2.  i.  and  2.  and  muft 
be  treated  accordingly. 

Other  kinds  of  vifual  hallucinations  occur  by  moon-light  ; 

when  objects  are  not  feen  fo  diftinctly  as  to  produce  the  ufual 

ideas  affociated  with  them,  but  appear  to  us  exactly  as  they  are 

feen.     Thus  the  trunk  of  a  tree  appears  a  flat  furfac^,  inftcad  of 

- 


DISEASES          CLASS  II.  i.  7.  6. 

a  cylinder  as  by  day,  and  we  are  deceived  and  alarmed  by  fee- 
ing things  as  they  really  are  feen.     See  Betkley  on  Vifion. 

6.  Hallucinate  audit&S*     Auricular  deception  frequently  oc-» 
curs  in  dreams,  and  fometimes  precedes  general  delirium  in  fe- 
vers j  and  fometimes  belongs  to  vertigo,  and  to  reverie,  and  to 
infanity.     See  Sett.  XX.  7.  and  Clafs  III.  i.  2.    1.  and  a. 

7.  Rubor  a  calore*  The  blufh  from  heat  is  occafioned  by  the  in- 
creafed  action  of  the  cutaneous  veffels  in  confequence  of  the  iu- 
creafed  fenfation  of  heat.     See  Clafs  I.  i.  2.  I.  and  3. 

8.  Rubor  jucuttditatis.     The  blufh  of  joy  is  owing  to  the  in- 
creafed  action  of  the  capillary  arteries,  along  with  that  of  every 
moving  veifcl  In  the  body,  from  the  increafe  of  pleafurable  fen- 
fation. 

9.  Priapifmus  atnatorius.     Amatorial  priapifm.     The  blood 
is  poured  into  the  cells  of  the  corpora  cavernofa  much  fafler  than 
it  can  be  reabforbed  by  the  vena  penis,  owing  in  this  cafe  to  the 
pleafurable  fenfation  of  love  increafmg  the  arterial  action.     See 
Clafs  I.   1.4.6. 

i  o.  D'tftentio  mamularitm.  The  teats  of  female  animals,  when 
they  give  fuck,  become  rigid  and  creeled,  in  the  fame  manner  as 
in  the  laft  article,  from  the  pleafurable  fenfation  of  the  love  of 
the  mother  to  her  offspring.  Whence  the  teat  may  properly  be 
called  an  organ  of  fenfe.  The  nipples  of  men  do  the  fame  when 
rubbed  with  the  hand.  See  Clafs  I.  I.  4,  7. 


ORDQ 

i 


Clafs  II.  a.  i.  i.         OF  SENSATION.  265 

ORDO    II. 

Decreafed  Senfation. 

GENUS  I. 

Of  the  General  Syjlem. 

SPECIES. 

1.  Stultitia  injenftbilis.     Folly  from  infenfibility.     The  pleaf- 
ure  or  pain  generated  in  the  fyftem  is  not  fufficient  to  promote 
the  ufual  activity  either  of  the  fenfual  or  mufcular  fibres. 

2.  Txdium  vita.     Ennui.     Irkfomenefs  of  life.     The  pain  of 
lazinefs  has  been  thought  by  fome  philofophers  to  be  that  prin- 
ciple of  action,  which  has  excited  all  our  induftry,  and  diftin- 
guifhed  mankind  from  the  brutes  of  the  field.     It  is  certain  that, 
where  the  ennui  exifts,  it  is  relieved  by  the   exertions  of  our 
minds  or  bodies,  as  all  other  painful  fenfations  are  relieved ; 
but  it  depends  much  upon  our  early  habits,  whether  we  become 
patient  of  lazinefs,  or  inclined  to  activity,  during  the  remainder 
of  our  lives,  as  other  animals  do  not  appear  to  be  affected  with  this 
malady  ;  which  is  perhaps  lefs  owing  to  deficiency  of  the  pleaf- 
urable  fenfation,  than  to  the  fuperabundancy  of  voluntary  pow- 
er which  occafions  pain  in  the  mufcles  by  its  accumulation  ;  as 
appears  from  the  perpetual  motions  of  a  fquirrel  confined  in  a 
cage. 

3.  Parefis  fenfttiva.     Weaknefs  of  the  whole  fyftem  from  in- 
fenfibility. 


VOL.  II.  -  L  i,  ORDO 


266  DISEASES  Clafs  II.  2.  2.  i. 

ORDO  II. 

Decrfafed  Senfatlon* 

GENUS  II. 

Of  particular  Organs. 

SPECIES. 

I .  Anorexia.  Want  of  appetite.  Some  elderly  people,  and 
thofe  debilitated  by  fermented  liquors,  are  liable  to  lofe  their 
appetite  for  animal  food  ;  which  is  probably  in  part  owing  to 
the  deficiency  of  gaftric  acid,  as  well  as  to  the  general  decay  of 
the  fyfteni :  elderly  people  will  go  on  years  without  animal  food  ; 
but  inebriates  foon  (ink,  when  their  digeftion  becomes  fo  far  im- 
paired. Want  of  appetite  is  fometimes  produced  by  the  putrid 
matter  from  many  decaying  teeth  being  perpetually  mixed  with 
the  faliva,  and  thence  affecting  the  organs  of  tafte,  and  greatly- 
injuring  the  digeftion. 

M.  M.  Fine  charcoal  powder  diffufed  in  warm  water,  held  in 
the  mouth  frequently  in  a  day,  as  in  Clafs  I.  i.  4.  4.  or  folution 
of  alum  in  water.  Extract  the  decayed  teeth.  An  emetic.  A 
blifter.  Chalybeates.  Vitriolic  acid.  Bile  of  an  ox  infpiiTated, 
and  made  into  pills ;  20  grains  to  be  taken  before  dinner  and 
fupper.  Opium  half  a  grain  twice  a  day. 

All  the  ftrength  we  poflefs  is  ultimately  derived  from  the 
food,  which  we  are  able  to  digeft  ;  whence  a  total  debility  of 
the  fyfteni  frequently  follows  the  want  of  appetite,  and  of  the 
power  of  digeftion.  Some  young  ladies  I  have  obferved  to  fall 
into  this  general  debility,  fo  as  but  juft  to  be  able  to  walk  about ; 
which  I  have  fometimes  afcribed  to  their  voluntary  fading, 
when  they  believed  themfelves  too  plump ;  and  who  have  thus 
loft  both  their  health  and  beauty  by  too  great  abftinence,  which 
could  never  be  reftored. 

Two  young  ladies  applied  to  me,  who  had  experienced  many 
months  of  great  debility,  and  of  almoft  total  want  of  appetite, 
from  another  caufe,  \vhich  was  from  bathing  0n  a  warm  day  iri 
a  cold  fountain  of  water,  which  was  covered  from  the  fun  and 
fupplied  by  a  powerful  fpring;  but  gradually  afterwards  recov- 
ered their  health  by  the  ufe  of  fix  grains  of  rhubarb  with  one 
gniin  of  opium  every  night  for  fome  weeks,  and  a  bitter  draught 
twice  a  day  with  a  flight  chalybeate.  See  Clafs  III.  2.  i.  17. 

I  have  feen  other  cafes  of  what  may  be  termed  anorexia  epi- 

Icptica, 


I 


CLASS  II.  2.  2.  2.         OF  SENSATION.  267 

leptica,  in  which  a  total  lofs  of  appetite,  and  of  the  power  of  di- 
geftion,  fuddenly  occurred  along  with  epileptic  fits.  Mifs  B.  a 
girl  about  eighteen,  apparently  very  healthy,  and  rather  plump, 
was  feized  with  fits,  which  were  at  firft  called  hyfterical ;  they 
occurred  at  the  end  of  menftruation,  and  returned  very  fre- 
uently  with  total  lofs  of  appetite.  She  was  relieved  by  vene- 
"eclion,  blifters,  and  opiates  ;  her  ftrength  dirninimed,  and  af- 
ter fome  returns  of  the  fits,  the  took  to  her  bed,  and  has  furvi- 
ved  15  or  20  years;  fhe  has  in  general  eaten  half  a  potato  a 
day,  and  feldom  fpeaks,  but  retains  her  fenfes,  and  had  many 
years  occafional  returns  of  convulfion.  I  have  feen  two  fimilar 
cafes,  where  the  anorexia,  or  want  of  appetite,  was  in  lefs  degree  ; 
and  but  juft  fo  much  food  could  be  digefted,  as  fupplied  them 
with  fufficient  ftrength  to  keep  from  the  bed  or  fofa  for  half  a 
day.  As  well  as  I  can  recollect,  all  thefe  patients  were  attend- 
ed with  weak  pulfe,  and  cold  pale  fkin  ;  and  received  benefit  by 
opium,  from  a  quarter  of  a  grain  to  a  grain  four  times  a  day. 
See  ClafsIII.  i.  i.  7.  and  III.  i.  2.  20.  and  Suppl.  I.  14.  3. 

2.  Adipfia.     Want  of  third.     Several  of  the  inferior  people, 
as  farmers'  wives,  have  a  habit  of  not  drinking  with  their  dinner 
at  all,  or  only  take  a  fpoonful  or    two  of  ale  after  it.     I  have 
frequently  oberved  thefe  to  labour  under  bad  digeftion,  and  de- 
bility in  confequence  ;    which  I  have  afcribed  to  the  too  great 
ftimulus  of  folid  food  undiluted,  deftroying  in  procefs  of  time 
the  irritability  of  the  ftomach. 

3.  Impotentia  (agene£a.)     Impotency  much  feldomer  happens 
to  the  male  fex  than  {rerility  to  the  female  fex.     Sometimes  a 
temporary  impotence  occurs  from  bafhfulnefs,  or   the  interfer- 
ence of  fome  voluntary  exertion  in  the  production  of  an  effect, 
which  ihould  be  performed  alone  by  pleafurable  fenfatiori. 

One,  who  was  foon  to  be  married  to  3  lady  of  fupenor  con- 
dition to  his  own,  exprefled  fear  of  not  fucceeding  on  the  wed- 
ding night ;  he  was  advifed  to  take  a  grain  of  opium  before  he 
went  to  bed,  and  to  accuftom  himfelf  to  fleep  with  a  woman 
previously,  but  not  to  enjoy  her,  to  take  off  his  baihfulnefs  ; 
which  fucceeded  to  his  wifh. 

Mr.  John  Hunter  in  his  work  on  the  Venereal  Difeafe,has  given 
an  ingenious  feclion  on  this  fubjecl  of  mental  impotence, in  which 
he  relates  a  fuccefsful  mode  of  treatment.  He  prevailed  on  aperfon 
in  this  fituation  to  promife  on  his  honor  to  pafs  fix  nights  in  bed 
with  a  young  woman  without  attempting  to  have  connection  with 
her,  whatever  might  be  his  power  or  inclination.  He  after- 
wards affured  Mr.  Hunter,  that  this  refolution  had  produced 
fuch  a  total  alteration  in  the  ftate  of  his  mind,  that  the  power  of 
connection  foon  recurred,  for  inftead  of  going  to  bed  with  the 

fear 


265  DISEASES  CLASS  II.  2.  3.  4. 

fear  of  inability,  he  went  with  fears,  that  he  ftiould  be  poflefT- 
ed  with  too  much  defire,  and  too  much  power,  fo  as  to  become 
uneafy  to  him,  which  really  happened,  as  he  would  have  been 
happy  to  have  (hortened  the  time  ;  and  when  he  had  once 
broken  the  fpell,  his  mind  and  powers  went  on  together ;  and 
his  mind  never  returned  to  its  former  ftate. 

A  gentleman  about  50  years  of  age,  who  had  lived  too  freely, 
as  he  informed  me,  both  in  refpecl:  to  wine  and  women,  com- 
plained, that  his  defire  for  the  fex  remained,  and  that  he  occa- 
fionally  parted  with  femen,  but  with  defect  of  a  perfect  tenfio 
penis,  and  that  he  had  tried  20  drops  of  laudanum,  and  20  drops 
of  tincture  of  cantharides  on  going  to  bed  without  efFecl:  ;  and 
that  as  the  debility  or  inirritability  of  the  fyftem  in  this  cafe 
rather  than  any  mental  affection  feemed  to  be  a  part  of  the 
cuufe,  he  was  advifed  to  ftimulate  the  fphin£ler  ani  by  the  in- 
troduction of  a  piece  of  the  root  of  ginger,  as  is  done  by  the 
horfe-dealers  to  fale-horfes.  And,  however  ridiculous  the  oper- 
ation may  appear,  he  allured  me,  that  it  fucceeded  ;  which  I 
fuppofe  might  be  owing  to  the  fympathy  between  the  fphindler 
am  and  the  penis  -,  which  is  fo  often  the  caufe  of  painful  fenfa- 
tion  in  the  former,  when  a  done  at  the  neck  of  the  bladder  af- 
fects the  latter  j  and  converfely  when  painful  piles  affect  the 
rectum,  a  ftrangury  is  fometimes  produced  by  fympathy. 

For  reftoring  the  venereal  power  M.  Le  Roy  thinks  phofpho- 
rus  taken  in  a  dofe  of  a  quarter  of  a  grain  rubbed  with  oil  or 
yolk  of  egg,  or  honey  ;  or  even  the  aci|^)f  phofphorus,  to  pof- 
fefs  great  efficacy.  Med.  Review,  Vol.'^v.  p.  204.  The  water 
in  which  phofphorus  has  been  kept  fome  time,  probably  pof- 
feifes  fome  of  this  acid,  and  is  alfo  recommended  by  M.  Le 
Roy.  I  ought  here  to  add,  that  I  have  been  lately  informed, 
that  a  gentleman  directed  four  grains  of  phofphorus  to  be  made 
into  pills  with  conferve,  with  defign  of  increafmg  his  venereal 
power.  He  was  feized  with  intolerable  fenfe  of  heat  at  his 
ftomach,  pulfe  feeble,  but  not  quickened,  livid  countenance, 
forenefa  of  his  bowels  to  the  touchvand  incefiant  vomitings,  by 
which  he  at  lafl  brought  up  fome  blood.  His  illnefs  laded  five 
or  fix  days.  He  did  not  acknowledge  any  caufe  of  his  fudden 
illnefs,  but  faid  he  was  certain  emetics  would  cure  him,  and  took 
two  by  his  own  requeft.  After  his  death,  the  apothecary  men- 
tioned his  having  directed  the  pills  as  above,  which  were  made 
three  days  before  lie  was  taken  ill  5  and  he  was  believed  to  have 
taken  about  half  of  them. 

M.  M.  Chalybeates.  Opium.  Bark.  Tincture  of  can- 
tharides, 

4.  Sterilitas.     Barrennefs.     One  of  the  ancient  medical  wri- 
ters 


CLASS  II.  2.  2.  5.        OF  SENSATION.  269 

ters  aflerts,  that  the  female  fex  become  pregnant  with  mod  cer- 
tainty at  or  near  the  time  of  menftrmtion.  This  is  not  im- 
probable, fince  thefe  monthly  periods  feem  to  refemble  the 
monthly  venereal  orgafm  of  feme  female  quadrupeds,  which  be- 
come pregnant  at  thofe  times  only ;  and  hence  the  computation 
of  pregnancy  is  not  often  erroneous,  though  taken  from  the  lad 
menftruation.  See  Section  XXXVI.  2.  3. 

M.  M.  Opium  a  grain  every  night.  Chalybeates  in  very 
fmall  dofes.  Bark.  Sea-bathing. 

5.  Infenfibilitas  artuum.    As  in  fome  paralytic  limbs.    A  great 
infenfibility  fometimes  accompanies  the  torpor  of  the  (kin  in  cold 
fits  of  agues.     Some  parts  have  retained  the  fenie  of  heat,  but 
not  the  fenfe  of  touch.     See  Sect.  XVI.  6. 

M.  M.    Friction  with  flannel.     A  blifter.     "Warmth. 

6.  Dyfiiria  infenfttiva.     Infenfibility  of  the  bladder.     A  diffi- 
culty or  total  inability  to  make  water  attends  fome  fevers  with 
great  debility,  owing  to  the  infenfibility  or  inirritability  of  the 
bladder.     This  is  a  dangerous  but  not  always  a  fatal  fymptom. 
SeeCJafsIII.  2.1.6. 

M.  M.  Draw  off  the  water  with  a  catheter.  Afiift  the  pa- 
tient in  the  exclufion  of  it  by  comprefling  the  lower  parts  of  the 
abdomen  with  the  hands.  Wine  two  ounces,  Peruvian  bark 
one  dram  in  decoction,  every  three  hours  alternately.  Balfam 
of  copaiva.  Oil  of  almonds, .  with  as  much  camphor  as  can  be 
diflblved  in  it,  applied  as  a  liniment  rubbed  on  the  region  of  the 
bladder  and  perinaeum,  and  repeated  every  four  hours,  was  ufed 
in  this  difeafe  with  fuccefs  by  Mr.  Latham.  Med.  Comment. 
1791,  p.  213. 

7.  Accumulate  alvina.     An   accumulation  of  feces  in  the 
rectum,  occafioned  by  the  torpor,  or  infenfibility,  of  that  bowel. 
But  as  liquids  pafs  by  thefe  accumulations,  it  differs  from  the 
conftipatio  alvi,  which  is  owing  to  too  great  abforption  of  the 
alimentary  canal. 

Old  milk,  and  efpecially  when  boiled,  is  liable  to  induce  this 
kind  of  coftivenefs  in  fome  grown  perfons  ;  which  is  probably 
owing  to  their  not  poflefiing  iufficient  gaftric  acid  to  curdle  and 
digeft  it  ;  for  as  both  thefe  procefles  require  gaftric  acid,  it  fol- 
lows, that  a  greater  quantity  of  it  is  neceflary,  than  in  the  digef- 
tion  of  other  aliments,  which  do  not  previoufly  require  being 
curdled.  This  ill  digefted  milk  not  fufficiently  ftimulating  the 
rectum,  remains  till  it  becomes  a  too  folid  mafs.  On  this  ac- 
count milk  feldom  agrees  with  thofe,  who  are  fubject  to  piles, 
by  inducing  coftivenefs  and  large  ftools. 

M.  M.  Extract  the  hardened  fcybala  by  means  of  a  marrow- 
fpoon  j  or  by  a  piece  of  wire,  or  of  whale-bone  bent  into  a  bow, 

and 


27*  DISEASES  CLASS  II.  «.  2/7. 

and  introduced.  Injections  of  oil.  Caftor  oil,  or  oil  of  al- 
monds, taken  by  the  mouth.  A  large  clyfter  of  fmoke  of  to- 
bacco. Six  grains  of  rhubarb  taken  every  night  for  many 
months.  Aloes.  An  endeavour  to  eftablilh  a  habit  of  evacua- 
tion at  a  certain  hour  daily.  See  Clafs  I.  i.  3.  5. 


ORDO 


CLASS  II.  3.  i.  i.          OF  SENSATION.  271 

ORDO    III. 

Retrograde  Senfttive  Motions. 

GENUS    I. 
Of  Excretory  Dufts. 

THE  retrograde  action  of  the  osfophagus  in  ruminating  ani* 
mals,  when  they  bring  up  the  food  from  their  firft  ftomach  for  the 
purpofe  of  a  fecond  maftication  of  it,  may  probably  be  caufed  by 
agreeable  fenfation  ;  fimilar  to  that  which  induces  them  to  fwal- 
low  it  both  before  and  after  this  fecond  maftication  ;  and  then 
this  retrograde  action  properly  belongs  to  this  place,  and  is  er- 
roneoufly  put  at  the  head  of  the  order  of  irritative  retrograde 
motions.  Clafs  I.  3.  I.  1. 

SPECIES. 

1.  Ureterum  motus  retrogrejfus.     When  a  (lone  has  advanced 
into  the  ureter  from  the  pelvis  of  the  kidney,  it  is  fometimes  lia- 
ble to  be  returned  by  the  retrograde  motion  of  that  canal,  and 
the  patient  obtains  fallacious  eafe,  till  the  ftone  is  again  puflied 
into  the  ureter. 

2.  Urethra  motus  retrogrejffus.     There  have  been  inftances  of 
bougies  being  carried  up  the  urethra  into  the  bladder  moft  prob- 
ably by  an  inverted  motion  of  this  canal ;  for  which  fome  have 
undergone  an  operation  fimilar  to  that  for  the  extraction  of  a 
ftone.     A  cafe  is  related,  in  fome  medical  publication,  in  which 
a  catgut  bougie  was  carried  into  the  bladder,  and,  after  remain- 
ing many  weeks,  was  voided  piece-meal  in  a  femi-diflblved  ftate. 
Another  cafe  is  related  of  a  French  officer,  who  ufed   a  leaden 
bougie ;  which  at  length   found  its  way  into  the  bladder,  and 
was,  by  injecting  crude  mercury,  amalgamated  and  voided. 

In  the  fame  manner  the  infection,  from  a  fimple  gonorrhcea, 
is  probably  carried  further  along  the  courfe  of  the  urethra ;  and 
fmall  ftones  frequently  defcend  fome  way  into  the  urethra,  and  are 
again  carried  up  into  the  bladder  by  theinverted  action  of  this  canal. 

3.  Duff  us  choledocki  motus  retrogrejffus.  The  concretions  of 
bile,  called  gall-ftones,  frequently  enter  the  bile-duct,  and  give 
violent  pain  for  fome  hours  ;  and  return  again  into  the  gall-blad- 
der, by  the  retrograde  action  of  this  duct.  May  not  oil  be  car- 
ried up  this  duct,  when  a  gall-ftone  gives  great  pain,  by  its  re- 
trograde fpafmodic  action ?  See  Clafs  I.  i.  3.  8. 

M.  M.  Opium  a  grain  and  half. 

72* 


27*  DISEASES  CLASS  III.  i.  i 

The  Orders  and  Genera  of  the  Third  Clafs  of  Difeafes. 
CLASS   III. 

DISEASES  OF  VOLITION. 

ORDO  I. 

Increafed  Volition. 

GENERA. 

I.  With  increafed  aftions  of  the  mufcles. 

2*  With  increafed  aclions  of  the  organs  of  fenfe. 

ORDO  IL 

Decreased  Volition, 
GENERA. 

1.  With  decreafed  actions  of  the  mufcles. 

2.  With  decreafed  actions  of  the  organs  of  fenfe. 


The  Orders,  Genera,  and  Species,  of  the  Third  Clafs  of 

Difeafes. 

CLASS   III. 

DISEASES  OF  VOLITION. 

ORDO  I. 

Increafed  Volition. 

GENUS  I. 

With  increafed  Aftions  of  the  Mufcles. 

SPECIES. 

1.  Ja&itatio.  Reftleflhefs. 

2.  Tremor  febrilis.  Febrile  trembling. 

3.  Clamor. 


CLASS  III.  1.2* 


OF  VOLITION. 


273 


Clamor. 

Rifus. 

Convtiljio. 


3- 
4- 

5- 

6.  - 

7.  Epilepfia. 

9- 
10. 
II. 

12. 


debilis. 
dolcrifica, 


14. 


dolorifica. 
Somnambulifmus. 
Afthma  convulfivum. 
•  dolorificum. 

Stridor  dcntium. 
Tetanus  trifmus. 

dolorificus. 


15.  Hydrophobia. 


Screaming. 

Laughter. 

Convulfion. 

weak. 

painful. 

Epilepfy. 

-       painful. 
Sleep-walking. 
Afthma  convulfive. 

painful. 

Gnafhing  of  the  teeth. 
Cramp  of  the  jaw. 

painful. 

Dread  of  water. 


GENUS   II. 


With  increafed  Actions  of  the  Organs  of  Senfe* 
SPECIES. 

Mutable  madnefs. 
Reverie. 
Watchfulnefs. 
Sentimental  love. 
Vanity. 

Defire  of  home. 
Superftitious  hope* 
Pride  of  family. 
Ambition. 
Grief. 

Irkfomenefs  of  life. 
Lofs  of  Beauty. 
Fear  of  poverty. 

of  death. 

of  Hell. 

Luft. 

Anger. 

Rage. 

Depraved  appetite. 

Averfion  to  food. 

Imaginary  pox. 

itch. 

tabes. 

Pity. 

Heroic  education. 


1.  Mania  mittabilis. 

2.  Studium  inane. 

3.  Vigilia. 

4.  Erotomania. 

5.  Amor  fm. 

6.  Noftalgia. 

7.  Spes  religiofa. 

8.  Superbia  jlemmatis. 

9.  Ambitlo. 

10.  Mosror. 

1 1 .  Txdium  vita. 

1 2.  Deftderium  pulchritudinis. 

13.  Paupertatis  timor. 

14.  Let  hi  timor. 

15.  Orel  timor. 

1 6.  Satyriafts. 

17.  Ira. 

1 8.  Rabies. 

19.  Citta. 

20.  Cacofttia. 

2 1 .  Syphilis  imaginana, 

22.  Pfora  imagitiaria. 

23.  Tabes  imaginana. 

24.  Sympathia  aliena. 
2.  E  due  at  lo  here/- 


VOL.  II. 


M  M 


ORDO 


274 


DISEASES 


CLASS  II.  2. 


7- 
8. 

9- 

10. 

ii. 

12- 


ORDO  II. 

Decreafed  Volition. 

GENUS  I. 

With  decreafed  Aclions  of  the  Mufcleu 
SPECIES. 


1.  LaJJitudo. 

2.  Vacillatio  fenilis. 
Tremor  fenilis. 
Brachiorum  paralyfis. 
Raucedo  paralytica. 


3 

4 
5 
6*  Vefica  urinaria  paralyftf. 


RecJi  paralyfis. 

Pare/is  voluntaria. 

Catalepjts. 

Hemiplegia. 

Paraplegia* 

Somnus. 

13.  Incubus. 

14.  Lethargits. 

15.  Syncope  epileptic  a. 
1  6.  Apoplexia. 

17.  M.QYS  a  f  rigor  e. 


Fatigue. 

See-faw  of  old  age. 

Tremor  of  old  age. 

Palfy  of  the  arms. 

Paralytic  hoarfenefs. 

Palfy  of  the  bladder. 

Palfy  of  the  reftum. 

Voluntary  debility. 

Catalepfy. 

Palfy  of  one  fide. 

Palfy  of  the  lower  limbs< 

Sleep. 

Night-mare. 

Lethargy. 

Epileptic  fainting. 

Apoplexy. 

Death  from  cold. 


GENUS  II. 


With  decreafed  Actions  of  the  Organs  of  Senfe. 
SPECIES. 


1 .  RecollecJionis  jacJura. 

2.  Stultitia  voluntaria. 

3.  Credulitas. 


Lofs  of  recolledlioit 
Voluntary  folly. 
Credulity. 


CLASS 


CLASS  III.  1. 1,  OF  VOLITION.  275 

CLASS  III. 

DISEASES   OF   VOLITION. 

ORDO  I. 

Increafed   Volition, 
GENUS  I. 

Increafed  Aftions  of  the  Mufcles. 

WE  now  ftep  forward  to  confider  the  difeafes  of  volition, 
that  fuperior  faculty  of  the  fenforium,  which  gives  us  the  pow- 
er of  reafon,  and  by  its  facility  of  action  diftinguiflies  mankind 
from  brute  animals  ;  which  has  effected  all  that  is  great  in  the 
world,  and  fuperimpofed  the  works  of  art  on  the  fituations  of 
nature. 

Pain  is  introduced  into  the  fyftem  either  by  excefs  or  defecl: 
of  the  action  of  the  part.  (Seel:.  IV.  5.)  Both  which  circum- 
ftances  feem  to  originate  from  the  accumulation  of  fenforial 
power  in  the  affected  organ.  Thus  when  the  (kin  is  expofed  to 
great  cold,  the  activity  04  the  cutaneous  veflels  is  diminifhed,  and 
in  confequence  an  accumulation  of  fenforial  power  obtains  in 
them,  becaufe  they  are  ufually  excited  into  inceilant  motion  by 
the  ftimulus  of  heat,  as  explained  in  Seel:.  XII.  5.  2.  Contra- 
rywife,  when  the  veflels  of  the  fldn  are  expofed  to  great  heat, 
an  excefs  of  fenforial  power  is  alfo  produced  in  them,  which  is 
derived  thither  by  the  increafe  of  ftimulus  above  what  is  natural. 

This  accounts  for  the  relief  which  is  received  in  all  kinds  of 
pain  by  any  violent  exertions  of  our  mufcles  or  organs  of  fenfe  ; 
which  may  thus  be  in  part  afcribed  to  the  exhauftion  of  the  fen- 
forial power  by  fuch  exertions.  But  this  relief  is  in  many  cafes 
fo  inftantaneous,  that  it  feems  neverthelefs  probable,  that  it  is 
alfo  in  part  owing  to  the  different  manner  of  progreffion  of  the 
two  fenforial  powers  of  fenfation  and  volition  j  one  of  them  com- 
mencing at  fome  extremity  of  the  fenforium,  and  being  propa- 
gated towards  the  central  parts  of  it ;  and  the  other  commenc- 
ing in  the  central  parts  of  the  fenforium,  and  being  propagated 
towards  the  extremities  of  it  ;  as  mentioned  in  Seel.  XL  2.  i. 

Thefe  violent  voluntary  exertions  of  our  mufcles  or  ideas  to, 
relieve  the  fenfation  of  pain  conftitute  convulfions  and  madnefs  ; 
and  are  diitinguifhed  from  the  mufcular  aclions  owing  to  in- 
creafcd  fenfation,  as  in  freezing,  or  coughing,  or  parturition,  or 

ejedlio 


DISEASES  CLASS  III.  i.r. 

eject  io  feminis,  becaufe  they  do  not  contribute  to  diflodge  the 
caufe,  but  only  to  prevent  the  fenfation  of  it.  In  two  cafes  of 
parturition,  both  of  young  women  with  their  firft  child,  I  have 
feen  general  convulfions  occur  from  excefs  of  voluntary  exer- 
tion, as  above  defcribed,  inflead  of  the  actions  of  particular  muf- 
cles,  which  ought  to  have  been  excited  by  fenfation  for  the  ex- 
clufion  of  the  fetus.  They  both  became  infenfible,  and  died  af- 
ter fome  hours  ;  from  one  of  them  the  fetus  was  extracted  in 
vain.  I  have  heard  alfo  of  general  convulfions  being  excited 
inftead  of  the  actions  of  the  mufculi  acceleratores  in  the  ejectio 
ieminis,  which  terminated  fatally.  See  Clafs  III.  i.  i.  7. 

Thefe  violent  exertions  are  moft  frequently  excited  in  cori- 
fequence  of  thofe  pains,  which  originate  from  defect  of  the 
action  of  the  part.  See  Sect.  XXXIV.  i.  and  2.  The  pains 
from  excefs  and  defect  of  the  action  of  the  part  are  diftin- 
guifhable  from  each  other  by  the  former  being  attended  with 
increafe  of  heat  in  the  pained  part,  or  of  the  whole  body ; 
while  the  latter  not  only  exift  without  increafe  of  heat  in  the 
pained  part,  but  are  generally  attended  with  coldnefs  of  the  ex- 
tremities of  the  body. 

As  foon  as  thefe  violent  actions  of  our  mufcular  or  fenfual 
fibres  for  the  purpofe  of  relieving  pain  ceafe  to  be  exerted,  the 
pain  recurs  ;  whence  the  reciprocal  contraction  and  relaxation 
of  the  mufcles  in  convulfion,  and  the  intervals  of  madnefs. 
Otherwife  thefe  violent  exertions  continue,  till  fo  great  a  part  of 
the  fenibrial  power  is  exhaufted,  that  no  more  of  it  is  excitable 
by  the  faculty  of  volition  ;  and  a  temporary  apoplexy  fucceeds, 
with  fnoring  as  in  profound  ileep  ;  which  fo  generally  termin- 
ates epileptic  fits. 

When  thefe  voluntary  exertions  become  fo  connected  with 
certain  difagreeable  fenfations,  or  with  irritations,  that  the  ef- 
fort of  the  will  cannot  reftrain  them,  they  can  no  longer  in  com- 
mon language  be  termed  voluntary  j  but  neverthelefs  belong  to 
this  clafs,  as  they  are  produced  by  excefs  of  volition,  and  may 
{till  not  improperly  be  called  depraved  voluntary  actions.  See 
Sect.  XXXIV.  i.  where  many  motions  in  common  language 
termed  involuntary  are  fhewn  to  depend  on  excefs  of  volition. 
When  thefe  exertions  from  excefs  of  volition,  which  in  com- 
mon language  are  termed  involuntary  motions,  either  of  mind 
or  body,  are  perpetually  exerted  in  weak  conftitutions,  the  pulfe 
becomes  quick  ;  which  is  occafioned  by  the  too  great  expendi- 
ture of  the  fenforial  power  in  thefe  unceafmg  modes  of  activity. 
In  the  fame  manner  as  in  very  weak  people  in  fevers,  the  pulfe 
fometimcs  incrcafes  in  frequency  to  14®  ftrokes  in  a  minute, 
when  the  patients  ftand  up  or  endeavour  to  walk  ;  and  fubfuies 

to 


CLASS  III.  i.  i.  OF  VOLITION.  277 

to  no,  when  they  lie  down  again  in  their  beds.  Whence  it 
appears,  that  when  a  very  quick  pulfe  accompanies  convulfion 
or  infanity,  it  limply  indicates  the  weakness  of  the  patient ;  that 
is,  that  the  expenditure  of  fenforial  power  is  too  great  for  the 
fupply  of  it.  But  if  the  ftrength  of  the  patient  is  not  previoufly 
exhaufted,  the  exertions  of  the  mufcles  are  attended  with  tem- 
porary increafe  of  circulation,  the  reciprocal  fwellings  and  elon- 
gations of  their  bellies  pufh  forwards  the  arterial  blood,  and 
promote  the  abforption  of  the  venous  blood  ;  whence  a  tempo- 
rary increafe  of  fecretion  and  of  heat,  and  a  ftronger  pulle. 

A  correfpondent  acquaints  me,  that  he  finds  difficulty  in  un- 
derftanding  how  the  convulfions  of  the  limbs  in  epilepfy  can  be 
induced  by  voluntary  exertions.  This  I  fufpect  firft  to  have 
arifen  from  the  double  meaning  of  the  words  "  involuntary  mo- 
tions ;"  which  are  fometimes  ufed  for  thofe  motions,  which  are 
performed  without  the  interference  of  volition,  as  the  pulfations 
of  the  heart  and  arteries ;  and  at  other  times  for  thofe  actions, 
which  occur,  where  two  counter  volitions  oppofe  each  other, 
and  the  ftronger  prevails  ;  as  in  endeavouring  to  fupprefs  laugh- 
ter, and  to  (top  the  mudderings  when  expofed  to  cold.  Thus 
when  the  poet  writes, 

video  meliora,  proboque, 

Deteriora  fequor. 

The  ftronger  volition  actuates  the  fyftem,  but  not  without  the 
counteraction  of  unavailing  fmaller  ones  ;  which  conftitute  de- 
liberation. 

A  fecond  difficulty  may  have  arifen  from  the  confined  ufe  of 
the  words  "  to  will,"  which  in  common  difcourfe  generally 
mean  to  choofe  after  deliberation  ;  and  hence  our  will  or  voli- 
tion is  fuppofed  to  be  always  in  our  own  power.  But  the  will 
or  voluntary  power,  acts  always  from  motive,  as  explained  in 
Sea  XXXIV.  i.  and  in  Clafs  IV.  i.  3.  2.  and  III.  2.  i.  12, 
which  motive  can  frequently  be  examined  previous  to  action, 
and  balanced  ngainlt  oppofitc  motives,  which  is  called  delibera- 
tion ;  at  other  times  the  motive  is  fo  powerful  as  immediately 
to  excite  the  fenforial  power  of  volition  into  action,  without  a 
previous  balancing  of  oppofite  motives,  or  counter  volitions. 
The  former  of  thefe  volitions  is  exercifed  in  the  common  pur- 
pofes  of  life,  and  the  latter  in  the  exertions  of  epilepfy  and  in- 
fanity. 

It  is  difficult  to  think  without  iuordrt  which  however  all  thofe 
mud  do,  who  difcover  new  truths  by  reafoning  •,  and  (lill  more 
difficult,  when  the  words  in  common  ufe  deceive  us  by  their 

twofold 


278  DISEASES  CLASS  III.  1. 1. 1. 

twofold  meanings,  or  by  the  inaccuracy  of  the  ideas,  which  they 
fuggeft. 

SPECIES. 

\.JaBitatw.  Reftleflhefs.  There  is  one  kind  of  reftleflhefs 
attending  fevers,  which  confifts  in  a  frequent  change  of  pofture 
to  relieve  the  uneafmefs  of  the  preflure  of  one  part  of  the  body 
upon  another,  when  the  fenfibility  of  the  fyftem,  or  of  fome 
parts  of  it,  is  increafed  by  inflammation,  as  in  the  lumbago; 
•which  may  foinetimes  be  diftinguifhed  in  its  early  ftage  by  the 
inceflant  defire  of  the  patient  to  turn  himfelf  in  bed.  But  there 
is  another  reftleffhefs,  which  approaches  towards  writhing  or 
contortions  of  the  body,  which  is  a  voluntary  effort  to  relieve 
pain  ;  and  may  be  efteemed  a  (lighter  kind  of  convulfion,  not 
totally  unreftrainable  by  oppofite  or  counteracting  volitions. 
..  Thus  when  a  fquirrel  is  confined  in  a  cage,  he  feels  uneafi- 
nefs  from  the  accumulation  of  fenforial  power,  in  his  mufcles, 
which  were  before  in  continual  violent  exertion  in  his  habits 
of  life  ;  and  in  this  lituation  finds  relief  by  perpetually  jump- 
ing about  his  cage  to  expend  a  part  of  this  accumulated  fenfo- 
rial power. 

For  the  fame  reafon  thofe  children,  who  are  conftrained  to  fit 
in  fome  fchools  for  hours  together,  are  liable  to  acquire  habits  of 
moving  fome  mufcles  of  their  faces,  or  hands,  or  feet,  which  are 
called  tricks,  to  exhauft  a  part  of  the  accumulated  fenforial  pow- 
er. Hence  reftleflhefs  is  occafioned  by  increafe  of  ftimulus,  or 
by  accumulation  of  fenforial  power. 

M.  M.  A  blifter.  Opium.  Warm  bath.  Bandage  on 
the  moving  mufcles.  See  Convulfio  debilis,  Clafs  III.  i.  i.  5. 
exercife. 

2.  ^Tremor  febnlts.  Reciprocal  convulfions  of  the  fubcu- 
taneous  mufcles,  originating  from  the  pain  of  the  fenfe  of 
heat,  owing  to  defeat  of  its  ufual  ftimulus,  and  confequent 
accumulation  of  fenforial  power  in  it.  The  actual  defi- 
ciency of  heat  may  exift  in  one  part  of  the  body,  and  the 
pain  of  cold  be  felt  mod  vividly  in  fome  other  part  aflbciated 
wit-h  it  by  fenfitive  fympathy.  So  a  chilnefs  down  the  back  is 
iirft  attended  to  in  ague-fits,  though  the  difeafe  perhaps  com- 
mences with  the  torpor  and  confequent  coldnefs  of  fome  inter- 
nal vifcus.  But  in  whatever  part  of  the  fyftem  the  defect  of 
heat  exift s,  or  the  fetifation  of  it,  the  convulfions  of  the  fubcu- 
taneous  mufcles  exerted  to  relieve  it  are  very  general ;  and,  if 
the  pain  is  ftill  greater,  a  chattering  of  the  teeth  is  added,  the 

more 


CLASS  III.  1.1.3.        OF  VOLITION.  279 

more  fuddenly  to  exhauft  the  fenforial  power,  and  becaufe  the 
teeth  are  very  fenfibie  to  cold. 

Thefe  convulfive  motions  are  neverthelefs  reftrainable  by  vi- 
olent voluntary  counteraction  ;  and  as  their  intervals  are  owing 
to  the  pain  of  cold  being  for  a  time  relieved  by  their  exertion, 
they  may  be  compared  to  laughter,  except  that  there  is  no  in- 
terval of  pleafure  preceding  each  moment  of  pain  in  this  as  in 
the  latter. 

M.  M.  Seel.  2.  2.  i. 

3.  Clamor.     Screaming  from  pain.     The  talkative  animals, 
as  dogs,  and  fwine,  and  children,  fcream  mod,  when  they  are  in 
pain,  and  even  from  fear  ;  as  they  have  ufed  this  kind  of  exer- 
tion from  their  birth  moft  frequently  and  molt  forcibly ;  and 
can  therefore  fooner  exhauft  the  accumulation  of  fenforial  pow- 
er in  the  affected  mufcular  or  fenfual  organs  by  this  mode  of 
exertion  ;  as  defcribed  in  Sea.  XXXIV.  1.3.     This  facility  of 
relieving  pain  by  fcreaming  is  the  fource  of  laughter,  as  explain- 
ed below. 

4.  Rifus.    The  pleafurable  fenfations,  which  occafion  laugh- 
ter, are  perpetually  pafRng  into  the  bounds  of  pain  ;  for  pleaf- 
ure and  pain  are  often  produced  by  different  degrees  of  the 
fame  ftimulus  ;  as  warmth,  light,  aromatic  or  volatile  odours, 
become  painful  by  their  excefs  ;  and  the  tickling  on  the  foles 
of  the  feet  in  children  is  a  painful  fenfation  at  the  very  time  it 
produces  laughter.     When  the  pleafurable  ideas,  which  excite 
us  to  laugh,  pafs  into  pain,  we  ufe  fome  exertion,  as  a  fcream, 
to  relieve  the  pain,  but  foon  (top  it  again,  as  we  are  unwilling 
to  lofe  the  pleafure  ;  and  thus  we  repeatedly  begin  to  fcream, 
and  flop  again  alternately.     So  that  in  laughing  there  are  three 
ftages,  firft  of  pleafure,  then  pain,  then  an  exertion  to  relieve 
that  pain.     See  Sett.  XXXIV.  1.3. 

Every  one  has  been  in  a  fituation,  where  fome  ludicrous  cir- 
cumftance  has  excited  him  to  laugh  ;  and  at  the  fame  time  a 
fenfe  of  decorum  has  forbid  the  exertion  of  thefe  interrupted 
fcreams  ;  and  then  the  pain  has  become  fo  violent,  as  to  occa- 
Con  him  to  ufe  fome  other  great  action,  as  biting  his  tongue, 
and  pinching  himfelf,  in  lieu  of  the  reiterated  fcreams  which 
conftitute  laughter. 

5.  Convulfw.     Convulfion.     When  the  pains  from  defect  or 
excefs  of  motion  are  more  diftrefling  than  thofe  already  defcrib- 
ed, and  are  not  relievable  by  fuch  partial  exertions,  as  in  fcream- 
ing, or  laughter,  more  general  convulsions  occur ;  which  vary 
perhaps  according  to  the  fituation  of  the  pained  part,  or  to  fome 
previous  affociations  formed  by  the  early  habits  of  life.     When 
thefc  convulfive  motions  bend  the  body  forwards,  they  are  term- 
ed 


;3o  DISEASES  CLASS  III.  i.i.g. 

ed  emprofthotoiioi  \  when  they  bend  it  backward,  they  are  term- 
ed opifthotonoi.  They  frequently  fucceed  each  other,  but  the 
epidhotonoi  are  generally  more  violent ;  as  the  mufcles,  which 
erect  the  body,  and  keep  it  creel,  arc  naturally  in  more  conftant 
and  more  forcible  action  than  their  antagonifts. 

The  caufes  of  convulfion  are  very  numerous,  as  from  tooth- 
ing in  children,  from  worms  or  acidity  in  their  bowels,  from 
eruption  of  the  diilinct  fmall-pox,  and  laftly,  from  breathing 
too  long  the  air  of  an  unventilated  bed-room.  Sir  G.  Baker, 
in  the  Tranfactions  of  the  College,  defcribed  this  difeafe,  and 
detected  its  cauie  ;  where  many  children  in  an  orphan-houfe 
were  crowded  together  in  one  chamber  without  a  chimney,  and 
were  almoft  all  of  them  affected  with  convulsion  ;  in  the  hof- 
pital  at  Dublin,  many  died  of  convulfions  before  the  real  caufc 
was  underilood.  See  Dr.  Beddoes's  Guide  to  Self-prefervation* 
In  a  large  family,  which  I  attended,  where  many  female  fervants 
Uept  in  erne  room,  which  they  had  contrived  to  render  inacceffi- 
ble  to  every  blaft  of  air  ;  I  faw  four  who  were  thus  feized  with 
convulfions,  and  who  were  believed  to  have  been  affected  by 
fympathy  from  the  iirft  who  fell  ill.  They  were  removed  into 
more  airy  apartments,  but  were  fome  weeks  before  they  all  re* 
gained  their  perfect  health. 

Convulfion  is  diitinguifhed  from  epilepfy,  as  the  patient  does 
not  intirely  lofe  all  perception  during  the  paroxyfm.  Which 
only  mews,  that  a  lefs  exhauftion  of  fenforial  power  renders  tol- 
erable the  pnins  which  caufe  convulfion,  than  thofe  which  caufe 
epilepfy.  The  hyftcric  convulfions  are  diltinguifhed  from  thofe, 
owing  to  other  caufes,  by  the  prefence  of  the  expectation  of 
death,  which  precedes  and  fucceeds  them,  and  generally  by  a 
flow  of  pale  urine  ;  thefe  convulfions  do  not  constantly  attend 
the  hyfleric  difeafe,  but  are  occafionally  fuperinduced  by  the 
cUfagreeable  fenfation  arifing  from  the  torpor  or  inverfion  of  a 
part  of  the  alimentary  canal.  Whence  the  convulfion  of  laugh- 
ter is  frequently  fuflicient  to  reftrain  thefe  hyfteric  pains,  which 
accounts  for  the  fits  of  laughter  frequently  attendant  on  this 
difeafe. 

M.  M.  To  remove  the  peculiar  pain  which  excites  the  con- 
vulfions.  Venefection.  An  emetic.  A  cathartic  with  calo- 
mel. Warm-bath.  Opium  in  large  quantities,  beginning  with 
fmaller  ones.  Mercurial  frictions.  Electricity.  Cold-bath  in 
the  paroxyfm  ;  or  cold  afperfion.  See  Memoirs  of  Med.  Soci- 
ety, Lon.  Vol.  III.  p.  147.  a  paper  by  Dr.  Currie. 

5.  Convulfto  debilis.  The  convulfions  of  dying  animals,  as  of 
fchofe  which  are  bleeding  to  death  in  the  flaughter-houfe,  are  an 
efTort  to  relieve  painful  fenfatiou,  either  of  the  wound  which 

occafions 


CLASS  III.  i.  i.  &        OF  VOLITION.  281 

occafions  their  death,  or  of  faintnefs  from  want  of  due  diften- 
tion  of  the  blood  velTels.  Similar  to  this  in  a  lefs  degree  is  the 
fubfultus  tendinum,  or  ftarting  of  the  tendons,  in  fevers  with  de- 
bility j  thefe  actions  of  the  mufcles  are  too  weak  to  move  the 
limb,  but  the  belly  of  the  acting  mufcles  is  feen  to  fwell,  and 
the  tendon  to  be  ftretched.  Thefe  weak  convulfions,  as  they 
are  occafioned  by  the  difagreeable  fenfation  of  faintnefs  from 
inanition,  are  fymptoms  of  great  general  debility,  and  thence 
frequently  precede  the  general  convulfions  of  the  act  of  dying. 
See  a  cafe  of  convulfion  of  a  mufcle  of  the  arm,  and  of  the  fore- 
arm, without  moving  the  bones  to  v/hich  they  were  attached* 
Sea.  XVII.  i.  8.  See  twitchingsof  the  face,  Clafs  IV.  i.  3.  2. 

6.  Convulfio  dolorifica.  Raphania.  Painful  convulfion.  In 
this  difeafe  the  mufcles  of  the  arms  and  legs  are  exerted  to  re- 
lieve the  pains  left  after  the  rheumatifm  in  young  and  delicate 
people  ;  it  recurs  once  or  twice  a  day,  and  has  been  miftaken  for 
the  chorea,  or  St.  Vitus's  dance  ;  but  differs  from  it,  as  the  un- 
due motions  in  that  difeafe  only  occur,  when  the  patient  endeav- 
ours to  exert  the  natural  ones ;  are  not  attended  with  pain ;  and 
ceafe,  when  he  lies  down  without  trying  to  move :  the  chorea, 
or  dance  of  St.  Vitus,  is  often  introduced  by  the  itch,  this  by  the- 
rheumatifm. 

It  has  alfo  been  improperly  called  nervous  rheumatifm ;  but 
is  diftinguifhed  from  rheumatifm,  as  the  pains  recur  by  peri- 
ods once  or  twice  a  day ;  whereas  in  the  chronic  rheumatifm 
they  only  occur  on  moving  the  affected  mufcles.  And  by  the 
warmth  of  a  bed  the  pains  of  the  chronic  rheumatifm  are  in- 
creafed,  as  the  mufcles  or  membranes  then  become  more  fenfi- 
ble  to  the  ftimulus  of  the  extraneous  mucaginous  material  de- 
pofited  under  them.  Whereas  the  pains  of  the  raphania,  or 
painful  convulfion,  commence  with  coidnefs  of  the  part,  or 
of  flie  extremities.  See  Rheumatifmus  chronicus.  Clafs  I. 
i.  3.  12. 

The  pains  which  accompany  the  contractions  of  the  mufcles 
in  this  difeafe,  feem  to  arife  from  the  too  great  violence  of  thofe 
contractions,  as  happens  in  the  cramp  of  the  calf  of  the  leg  5 
from  which  they  differ  iu  thofe  being  fixed,  and  thefe  being  re- 
iterated contractions.  Thus  thefe  convulfions  are  generally  of 
the  lower  limbs,  and  recur  at  periodical  times  from  fome  unea- 
fy  ienfation  from  defect  of  action,  like  other  periodic  difeafesj 
and  the  convulfions  of  the  limbs  relieve  the  original  uneafy  pain- 
ful fenfation,  and  then  produce  a  greater  pain  irom  their  own 
too  vehement  contractions.  There  is  however  another  way  of 
accounting  for  thefe  pains,  wheq  they  fucceeci  the  acute  rheu- 
matifm ;  and  that  is  by  the  coagulable  lymph,  which  may  be 

VOL.  II.  NN  left 


DISEASES  CLASS  HI.  r.  i.  7, 

ftill  unabforbed  on  the  membranes  5  and  which  may  be  in  too 
fmall  quantity  to  affeft  them  with  pain  in  common  mufcular 
exertions,  but  may  produce  great  pain,  when  the  bellies  of  th« 
mufcles  fwell  to  a  larger  bulk  in  violent  action. 

M.  M.  Venefeetion.  Calomel.  Opium.  Bark.  One  grain 
of  calomel  and  one  of  opium  for  ten  fucceffive  nights.  A  ban- 
dage fpread  with  emplaflrum  de  minio  put  tight  on  the  affected 
part. 

7.  Epilepfta  is  originally  induced,  like  other  convulfions,  by  a 
voluntary  exertion  to  relieve  fome  pain.  This  pain  is  molt  fre- 
quently about  the  pit  of  the  ftomach,  or  termination  of  the  bile- 
duct  j  and  in  fome  cafes  the  torpor  of  the  ftomach,  which  prob- 
ably occafion&I  the  epileptic  fits,  remains  afterwards,  and  pro- 
duces a  chronical  anorexia ;  of  which  a  cafe  is  related  in  Clafs 
II.  2.  2.  I.  There  are  inftances  of  its  beginning  in  the  heel, 
of  which  a  cafe  is  publifhed  by  Dr.  Short,  in  the  Med.  Effays. 
Edinb.  I  once  faw  a  child  about  ten  years  old,  who  frequently 
fell  down  hi  convuifions,  as  fhe  was  running  about  in  play  j  on 
examination  a  wart  \vas  found  on  one  ancle,  which  was  ragged 
and  inflamed  •,  which  was  directed  to  be  cut  off,  and  the  fits 
never  recurred. 

When  epilepfy  firft  commences,  the  patients  are  liable  to  ut*- 
ter  one  fcream  before  they  fall  down  ;  afterwards  the  convul- 
fions fo  immediately  follow,  the  pain,  whrch  occafions  them, 
that  the  patient  does  not  recollect  or  feem  fenfible  of  the  pre- 
ceding pain.  Thus  in  laughter,  when  it  is  not  exceffive,  a  per- 
fon  is  not  confcious  of  the  pain,  which  fo  often  recurs,  and  cauf- 
es  the  fucceffive  fcreams  or  exertions  of  laughter,  which  give  a 
temporary  relief  to  it. 

Epileptic  fits  frequently  recur  in  fleep  from  the  increafe  of 
fenfibilky  at  that  time,  explained  in  Seel.  XVIII.  1 4.  In  two 
fuch  cafes,  both  of  young  women,  one  grain  of  opium  given  at 
night,  and  continued  many  months,  had  fuccefs ;  in  one  of  them 
the  opium  was  omitted  twice  at  different  times,  and  the  fit  re- 
curred on  both  the  nights.  In  the  more  violent  cafe,  defcribed 
in  Seel:.  XVIII.  15,  opium  had  no  effect. 

Epileptic  fits  generally  commence  with  fetting  the  teeth,  by 
which  means  the  tongue  is  frequently  wounded  ;  and  with  roll- 
ing the  eye-balls  in  every  kind  of  direction  ;  for  the  mufcles 
which  fufpend  the  jaw,  as  well  as  thofe  which  move  the  eyes, 
:ire  in  perpetual  motion  during  our  waking  hours  •,  and  yet  con- 
tinue fubfervient  to  volition  ;  hence  their  more  facile  and  forci- 
ble actions  for  the  purpofe  of  relieving  pain  by  the  exhauftion 
of  fenforial  power.  See  Section  XXXIV.  i.  4. 

Epileptic  convulfions  are  not  attended  with  the  fear  of  death, 

as 


CLASS  III.  1.1.7.        OF  VOLITION.  283 

as  in  the  hyfteric  difeafe,  and  the  urine  is  of  a  ftraw  colour. 
However  it  muft  be  noted,  that  the  difagreeable  filiations  in 
hyfteric  difeafes  fometimes  are  the  caufe  of  true  epileptic  con- 
vulfions,  of  fyncope,  and  of  madnefs. 

The  pain,  which  occafions  fome  fits  of  epilepfy,  is  felt  for  a 
time  in  a  diftant  part  of  the  fyftem,  as  in  a  toe  or  heel ;  and  is 
faid  by  the  patient  gradually  to  afcend  to  the  head,  before  the 
general  convulfions  commence.  This  afcending  fenfation  has 
been  called  aura  epileptica,  and  is  faid  to  have  been  prevented 
from  affeding  the  head  by  a  tight  bandage  round  the  limb.  In 
this  malady  the  pain,  probably  of  fome  torpid  membrane,  or  dif- 
eafed  tendon,  is  at  firft  only  fo  great  as  to  induce  flight  fpafms 
of  the  mufcular  fibres  in  its  viciuity ;  which  flight  fpafms  ceafe 
on  the  numbnefs  introduced  by  a  tight  bandage ;  when  no  band- 
age is  applied,  tHb  pain  gradually  increafes,  till  general  convul- 
fions are  exerted  to  relieve  it.  The  courfe  of  a  lymphatic,  as 
when  poifonous  matter  is  abforbed ;  or  of  a  nerve,  as  in  the 
fciatica,  may,  by  the  fympathy  exifting  between  their  extremi- 
ties and  origins,  give  an  idea  of  the  afcent  of  an  aura  or  va- 
pour. 

In  difficult  parturition  it  fometimes  happens,  that  general  con- 
vulfions are  excited  to  relieve  the  pain  of  labour,  inftead  of  the 
exertions  of  thofe  mufcles  of  the  abdomen  and  diaphragm,  which 
ought  to  forward  the  exclufion  of  the  child.  See  Clafs  III.  I.  i. 
That  is,  inftead  of  the  particular  mufcular  adions,  which  ought  to 
be  excited  by  fenfation  to  remove  theoffending  caufe,general  con- 
vulfions are  produced  by  the  power  of  volution,  which  ftill  the 
pain,  as  in  common  epilepfy,  without  removing  the  caufe ;  and, 
as  the  parturition  is  not  thus  promoted,  the  convulfions  con- 
tinue, till  the  fenforial  power  is  totally  exhaufted,  that  is,  till 
death.  In  patients  afflided  with  epilepfy  from  other  caufes, 
I  have  feen  the  moft  violent  convulfions  recur  frequently  dur- 
ing pregnancy  without  mifcarriage  ;  as  they  did  not  tend  to 
forward  the  exclufion  of  the  fetus. 

Pains  of  this  kind  have  been  called  falfe  pains  by  fome  writers 
on  midwifery,  and  are  directed  to  be  relieved  by  an  opiate,  and 
then  they  fay  the  true  pains  will  commence.  M.  Daventer  di- 
rects the  accoucheur  to  attend  to  the  os  tincse,  to  diftinguifh 
them  from  each  other,  which  dilates  with  every  true  pain,  but 
contracts  with  every  falfe  one,  that  is,  the  voluntary  actions  of 
other  mufcles  to  relieve  pain  are  attended  with  thofe  of  the  os 
uteri,  as  mentioned  in  Genus  I.  of  this  Clafs  and  Order  prece- 
ding the  defcription  of  the  Species. 

M.  M.  Venefedion.     A  large  dofe  of  opium.     Delivery. 

The  later  in  life  epileptic  fits  are  firft  experienced,  the  more 

dangerous 


284  DISEASES  CLASS  III.  1. 1. 7. 

dangerous  they  may  be  efteemed  in  general ;  as  in  thefe  cafes 
the  caufe  has  generally  been  acquired  by  the  habits  of  the  pa- 
tient, or  by  the  decay  of  fome  part,  and  is  thus  probably  in  an 
increafing  Hate.  Whereas  in  children  the  change  in  the  fyk 
tern,  as  they  advance  to  puberty,  fometimes  removes  the  caufe. 
So  in  toothing,  fits  of  convulfion  with  ftupor  frequently  occur, 
and  ceafe  when  the  tooth  advances ;  but  this  is  not  to  be  ex- 
pected in  advanced  life.  Sir ,  about  fixty  years  of 

age,  had  only  three  teeth  left  in  his  upper  jaw,  a  canine  tooth, 
and  one  on  each  fide  of  it.  He  was  feized  with  epileptic 
fits,  with  pain  commencing  in  thefe  teeth.  He  was  urged  to 
have  them  extracted,  which  he  delayed  too  long,  till  the  fits 
were  become  habitual,  and  then  had  them  extracted  in  vain, 
and  in  a  few  months  funk  under  the  difeafe. 

Mr.  H.  M.  was  feized  with  pain  in  the  adductor  mufcle  of 
the  right  thumb,  and  had  epileptic  convulfions  in  confequence ; 
thefe  gradually  increafed  in  ftrength  and  frequency ;  a  bandage 
on  the  arm,  drawn  very  tight  as  foon  as  the  pain  of  the  ball  of 
the  thumb  commenced,  prevented  the  epileptic  fits,  I  fuppofe 
by  leflening  the  pain  by  the  numbnefs  occafioned  by  comprefting 
the  nerve.  I  advifed  the  nerves  of  this  mufcle  to  be  cut,  which 
was  done  or  attempted,  and  was  fuppofed  for  a  time  to  have 
cured  the  difeafe,  as  I  was  informed.  Afterwards  it  recurred 
and  deftroyed  the  patient,  who  might  have  probably  been  faved 
by  the  lofs  of  a  hand,  which  I  (hould  have  advifed,  but  was  not 
again  confulted. 

I  have  to  add,  that  the  tic  douloureux,  or  hemicrania  idio- 
pathica,  I  believe  to  be  a  difeafe  of  this  kind,  owing  to  a  torpor 
of  the  extremity  of  fome  branch  of  a  nerve,  and  fhould  recom- 
mend, when  the  nerve  cannot  be  bifected,  to  pafs  through  it 
for  many  hours  or  even  days,  a  current  of  galvanic  electricity 
from  Volta's  pillar  of  zinc,  and  filver,  and  cloth  moiftened  with 
fait  and  water. 

Mr.  F ,  who  had  lived  intemperately,  and  had  been  oc- 

cafionally  affected  with  the  gout,  was  fuddenly  feized  with  epi- 
leptic fits  ;  the  convulfions  were  fucceeded  by  apoplectic  fnor- 
ing  ;  from  which  he  was,  in  about  20  minutes,  diflurbed  by 
frem  convulfions,  and  had  continued  in  this  fituation  above  four- 
and-twenty  hours.  About  eight  ounces  of  blood  were  then  taken 
from  him  :  and  after  having  obferved,  that  the  apoplectic  tor- 
por continued  about  20  minutes, I  directed  him  to  be  forcibly  raif- 
ed  up  in  bed,  after  he  had  thus  lain  about  fifteen  minutes,  to  gain 
an  interval  between  the  termination  of  the  fleep,  and  the  reno- 
vation of  convulfion.  In  this  interval  he  was  induced  to  fwal- 
low  forty  drops  of  laudanum.  Twenty  more  were  given  him 

in 


CLASS  III.  1.1.7.        OF  VOLITION.  285 

» 

in  the  fame  manner  in  about  half  an  hour,  both  which  evidently 
(hortened  the  convulfion  fits,  and  the  confequent  ilupor  ;  he 
then  took  thirty  more  drops,  which  for  the  prefent  removed  the 
fits.  He  became  rather  infane  the  next  day,  and  after  about 
three  more  days  loft  the  infanity,  and  recovered  his  ufual  ftate 
of  health. 

The  cafe  mentioned  in  Sect.  XXVII.  2.  where  the  patient 
was  left  after  epileptic  fits  with  a  fuffufion  of  blood  beneath  the 
tunica  adjuncliva  of  the  eye,  was  in  almofl  every  refpect  fimilar 
to  the  preceding,  and  fubmitted  to  the  fame  treatment.     Both 
of  them  fuffered  frequent  relapfes,  which  were  relieved  by  the 
fame  means,  and  at  length  periflied,  I  believe,  by  the  epileptic  fits. 
In  thofe  patients,  who  have  not  been  fubjecl  to  epilepfy  be- 
fore  they  have  arrived  to  about  forty  years  of  age,  and  who 
have  been  intemperate  in  refpe<!t  to  fpirituous  potation,  I  have 
been  induced  to  believe,  that  the  fits  were  occafioned  by  the 
pain  of  a  difeafed  liver  ;  and  this  became  more  probable  in  one 
of  the  above  fubje&s,  who  had  ufed  means  to  repel  eruptions 
on  the  face  ;  and  thus  by  fome  ftimularrt  application  had  pre- 
vented an  inflammation  taking  place  on  the  fkin  of  the  face  in- 
ilead  of  on  fome  part  of  the  liver.    Secondly,  as  in  thefe  cafes  in- 
fanity had  repeatedly  occurred,  which  could  not  be  traced  from 
an  hereditary  fource  ;  there  is  reafon  to  believe,  that  this  as  well 
as  the  epileptic  convulOons  were  caufed  by  fpirituous  potation  ; 
and  that  this  therefore  is  the  original  fource  both  of  epilepfy 
and  of  infanity  in  thofe  families,  which  are  afflifted  with  them. 
This  idea  however  brings  fome  confolation  with  it;  as  it  mayj»e 
inferred,  that  in  a  few  fober  generations  thefe  difeafes  may  be 
eradicated,  which  otherwife  deftroy  the  family. 

M.  M.  Venefeclion.  Opium.  Bark.  Steel.  Arfenic. 
Opium  one  grain  twice  a  day  for  years  together.  See  the  pre- 
ceding article,  and  the  fucceeding  one. 

Anorexia  epilepticat  as  mentioned  in  ClafsII.  2.  2.  I.  is  a  dread- 
ful difeafe,  originating,  I  believe,  from  a  paralyfis  of  the  ftorh- 
ach,  and  generally  occafioned  by  the  application  of  great  exter- 
nal cold  to  the  fkin.  A  young  lady,  whom  I  faw  yefterday,  who 
had  long  experienced  a  weak  fiate  of  health,  went  to  church  on 
an  uncommonly  cold  Sunday,  when  the  thermometer  was  faid 
to  ftand  below  20  during  the  whole  day.  "She  became  immedi- 
ately indifpofed,  and  was  feized  in  a  day  or  two  with  tremors 
and  convulfions  in  her  fleep  ;  and  which  returned  every  two  or 
three  days.  Her  extremities  are  now  always  uncommonly  cold, 
and  her  appetite  to  food  totally  defective.  She  took  three  drops 
of  a  faturated  folution  of  arfenic  and  a  bitter  draught  twice  a  day 
for  a  fortnight,  and  gradually  recovered  her  former  ftate  of  health. 

Another 


286  DISEASES  CLASS  III.  i.  i.  8. 

Another  young  lady,  whom  I  lately  faw,  began  to  ftart  fome- 
what  like  a  violent  hiccough  many  times  in  an  hour,  after  ufing 
a  very  cold  fhower-bath  repeatedly.  This  had  continued  daily 
at  uncertain  times  for  many  months,  and  received  temporary 
advantage  from  one  drop  of  oil  of  cinnamon,  three  or  four 
times  a  day,  on  powdered  fugar ;  this  cafe  belongs  to  convulfion 
rather  than  epilepfy,  but  was  attended,  like  the  former,  with 
great  defea  of  appetite.  In  both  thefe  cafes  I  fufpeft,  that  the 
great  torpor  of  the  ftomach  was  caufed  by  too  violent  or  too 
long  continued  coldnefs  applied  to  the  fkin  ;  whence  the  fenfo- 
rial  power  of  alTociation,  which  ought  to  have  been  excited  by 
the  action  of  the  cutaneous  veflels,  and  to  have  then  contributed 
to  the  aclion  of  the  ftomach,  did  not  exift  ;  and  that  the  ftom- 
ach in  confequence  became  torpid.  See  Suppl.  I.  14.  3.  and 
Art.  IV.  2.  6.  8.  and  Clafs  III.  2.  i.  17. 

Dr.  Wilfon,  of  Spalding,  has  lately  much  recommended  the 
argentum  nitratum  in  epilepfy  ;  he  gives  two  grains  and  a  half 
three  times  a  day,  mixed  with  bread  crumbs  into  pills,  as  he  af- 
ferts,  with  the  happieft  fuccefs.  Annals  of  Medicine,  1797. 

8.  Epilepfia  dolorifica.  Painful  epilepfy.  In  the  common 
epilepfy  the  convulfions  are  immediately  induced,  as  foon  as  the 
difagreeable  fenfation,  which  caufes  them,  commences  ;  but  in 
this  the  pain  continues  long  with  cold  extremities,  gradually  in- 
creafmg  for  two  or  three  hours,  till  at  length  convulfions  or  mad- 
nefs  come  on  ;  which  terminate  the  daily  paroxyfm,  and  ceafo 
themfelves  in  a  little  time  afterwards. 

This  diieafe  fometimes  originates  from  a  pain  about  the  lower 
edge  of  the  Hver,  fometimes  in  the  temple,  and  fometimes  in  the 
pudendum  ;  it  recurs  daily  for  five  or  fix  weeks,  and  then  ceafes 
for  feveral  months.  The  pain  is  owing  to  defecl:  of  adlion,  that 
is,  to  the  accumulation  of  fenforial  power  in  the  part,  which 
probably  fympathizes  wkh  fome  other  part,  as  explained  in 
Sea.  XXXV.  2.  XII.  5.  3.  and  Clafs  II.  i.  i.  1 1.  and  IV.  2.  2.  3. 

It  is  the  moft  painful  malady  that  human  nature  is  liable  to  ! — 
See  Sea.  XXXIV.  i.  4. 

Mrs.  C was  feized  every  day  about  the  fame  hour  with 

violent  pain  on  the  right  fide  of  her  bowels  about  the  fituation 
of  the  lower  edge  of  the  liver,  without  fever,  which  increafed 
for  an  hour  or  two,  till  it  became  totally  intolerable.  After 
violent  fcreaming  me  fell  into  convulfions,  which  terminated 
fometimes  in  fainting,  with  or  without  ftertor,  as  in  common 
epilepfy  \  at  other  times  a  temporary  infanity  fupenvened  ; 
which  continued  about  half  an  hour,  and  the  fit  ceafed.  Thefe 
paroxyfms  had  returned  daily  for  two  or  three  weeks,  and  were 
at  length  removed  by  large  dofes  of  opium,  like  the  fits  of  re- 
verie 


CLASS  III.  1. 1.  8.        OF  VOLITION.  287 

verie  or  fomnambulation.  About  half  an  hour  before  the  ex- 
pelled return  of  the  fit  three  or  four  grains  of  opium  were  ex- 
hibited, and  then  tincture  of  opium  was  given  in  warm  brandy 
and  water  about  twenty  or  thirty  drops  every  half  hour,  till  the 
eyes  becarre  fomewhat  inflamed,  and  the  nofe  began  to  itch, 
and  by  the  {harp  movements  of  the  patient,  or  quick  fpeech,  an 
evident  intoxication  appeared  ;  and  then  it  generally  happened 
that  the  pain  ceafed.  But  the  effects  of  this  large  dofe  of  opium 
was  fucceeded  by  perpetual  ficknefs  and  efforts  to  vomit,  with 
great  general  debility  all  the  fucceeding  day. 

The  rationale  of  this  temporary  cure  from  the  exhibition  of 
opium  and  vinous  fpirit  depends  on  the  great  expenditure  of 
fenforial  power  in  the  increafed  actions  of  all  the  irritative  mo- 
tions, by  the  ftimulus  of  fuch  large  quantities  of  opium  and  vi- 
nous fpirit  ;  together  with  the  production  of  much  fenfation, 
and  many  movements  of  the  organs  of  fenfe  or  ideas  in  confe- 
quence  of  that  fenfation  ;  and  laftly,  even  the  motions  of  the 
arterial  fyftem  become  accelerated  by  this  degree  of  intoxica- 
tion, all  which  foon  exhaufted  fo  much  fenforial  power  as  to  re- 
lieve the  pain  ;  which  would  otherwife  have  caufed  convuiiions 
or  infanity,  which  are  other  means  of  expending  fenforial  pow- 
er. The  general  debility  on  the  fucceeding  day,  and  the  partic- 
ular debility  of  the  ftomach,  attended  in  confequence  with  fick- 
nefs and  frequent  efforts  to  vomit,  were  occafioned  by  the  fyf- 
tem having  previoufly  been  fo  flrongly  ftimulated,  and  thofe 
parts  in  particular  on  which  the  opium  and  wine  more  imme- 
diately a&ed.  This  ficknefs  continued  fo  many  hours  as  to 
break  the  catenation  of  motions,  which  had  daily  reproduced 
the  paroxyfm  ;  and  thus  it  generally  happened,  that  the  whole 
difeafe  ceafed  for  fome  weeks  or  months  from  one  great  intoxi- 
cation, a  circumftance  not  eafily  to  be  explained  on  any  other 
thoiry. 

Ths  excefs  or  defect:  of  motion  in  any  part  of  the  fyftem  oc- 
cafions  the  production  of  pain  in  that  part,  as  in  Seel:.  XII.  i .  6'. 
This  defect:  or  excefs  of  fibrous  action  is  generally  induced  by 
excefs  or  defect,  of  the  ftimulus  of  objefts  external  to  the  mov- 
ing organ.  But  there  is  another  fource  of  excelfive  fibrous  ac- 
tion, and  confequent  pain,  which  is  from  excefs  of  volition, 
which  is  liable  to  affect  thofe  mufcles,  that  have  weak  antago- 
rufts  ;  as  thofe  which  fupport  the  under  jaw,  and  clofe  the  mouth 
in  biting,  and  thofe  of  the  calf  of  the  leg  ;  which  are  thus  liable 
to  fixed  or  painful  contractions,  as  in  trifmus,  or  locked  jaw,  and 
in  the  cramp  of  the  calf  of  the  leg  ;  and  perhaps  in  fome  colics, 
as  in  that  of  Japan  :  thefe  pains,  from  contraction  arifing  from 
excefs  of  volition  in  the  part  from  the  want  of  the  counteraction 


DISEASES  CLASS  III.  1.1*8. 

of  antagoniil  mufcles,  may  give  occafional  caufc  to  epileptic  fits, 
and  may  be  relieved  in  the  fame  way,  either  by  exciting  irrita- 
tive and  fenfltive  motions  by  the  flimulus  of  opium  and  wine  ; 
or  by  convulfions  or  infunity,  as  defcribed  above,  which  are  only 
different  methods  of  exhaufting  the  general  quantity  of  fenfori- 
al  power. 

Confidering  the  great  refemblance  between  this  kind  of  pain- 
ful epilepfy  and  the  colic  of  Japan,  as  defcribed  by  Kaempfer ; 
and  that  that  difeafe  was  faid  to  be  cured  by  acupuncture,  or  the 
prick  of  a  needle  j  I  directed  fome  very  thin  fteel  needles  to  be 
made  about  three  inches  long,  and  of  fuch  a  temper,  that  they 
wowld  bend  double  rather  than  break  ;  and  wrapped  wax  thread 
over  about  half  an  inch  of  the  blunt  end  for  a  handle.  One  of 
thefe  needles,  when  the  pain  occurred,  was  pufhed  about  an 
inch  into  the  painful  part,  and  the  pain  inflantly  ceafed  j  but  I 
was  not  certain,  whether  the  fear  of  the  patient,  or  the  ftimulus 
-of  the  puncture,  occafioned  the  ceffation  of  pain  ;  and  as  the 
paroxyfm  had  continued  fome  weeks,  and  was  then  declining, 
the  experiment  was  not  tried  again.  The  difeafe  is  faid  to  be 
very  frequent  in  Japan,  and  its  feat  to  be  in  the  bowels,  and 
that  the  acupuncture  eliminates  the  air,  which  is  fuppofed  to 
diftend  the  bowel.  But  though  the  aperture  thus  made  is  too  fmall 
to  admit  of  the  eduction  of  air  ;  yet  as  the  ftimulus  of  ib  frfiall 
a  puncture  may  either  excite  a  torpid  part  into  action,  or  caufe 
a  ipafmodic  one  to  ceafe  to  act  ;  and  laftly,  as  no  injury  could 
be  likely  to  enfue  from  fo  fmall  a  perforation,  I  fhould  be  in- 
clined at  forne  future  time  to  give  this  a  fairer  trial  in  fimilar 
circumftances. 

Another  thing  worth  trial  at  the  commencen^ent  of  this  de- 
plorable difeafe  would  be  electricity,  by  paffing  itr^ng  mocks 
through  the  painful  part ;  which,  whether  the  pain  was  owing 
to  the  inaction  of  that  part,  or  of  fome  other  membrane  aflbci- 
ated  with  it,  might  ftimulate  them  into  exertion  ;  or  into  inac- 
tivity, if  owing  to  fixed  painful  contraction. 

And  laftly,  the  cold  bath,  or  afperfions  with  cold  water  on  the 
affected  part,  according  to  the  method  of  Dr.  Currie  in  the  Me- 
moirs of  a  Med.  Sot.  London,  Vol.  III.  p.  147,  might  produce 
great  effect  at  the  commencement  of  the  pain.  Neverthelefs 
opium  duly  adminiftered,  fo  as  to  precede  the  expected  parox- 
yfm, and  in  fuch  dofes,  given  by  degrees,  as  to  induce  intoxica- 
tion, is  principally  to  be  depended  upon  in  this  deplorable  mala- 
dy. To  which  fhould  be  added,  that  if  venefection  can  be  previ- 
oufly  performed,  even  to  but  few  ounces,  the  effect  of  the  opium 
is  much  more  certain  ;  and  ilill  more  fo,  if  there  be  time  to  pre- 
mifc  n.  briilc  cathartic,  or  even  an  emetic.  The  effect  of  increaf- 

ed 


CLASS  III.  i .  i .  $.        OF  VOLITION.  289 

ed  ftimulus  is  fo  much  greater  after  previous  defect  of  ftimulus ; 
and  this  is  ftill  of  greater  advantage,  where  the  caufe  of  the  d\i- 
cafe  happens  to  coniift  in  a  material,  which  can  be  abforbed. 
See  Art.  IV.  2.  8. 

M.  M.  Venefection.  An  emetic.  A  cathartic.  Warm 
bath.  Opiurri  a  grain  every  half  hour.  Wine.  Spirit  of  wine. 
If  the  patient  becomes  intoxicated  by  the  ^bove  means,  the  fit 
ceafes,  and  violent  vomitings  and  debility  fucceed  on  the  fubfe- 
quent  day,  and  prevent  a  return.  Blifters  or  (inapifms  on  the 
fmall  of  the  leg,  taken  off  when  they  give  much  pain,  are  of  ufe 
in  /lighter  convulfions.  Acupuncture.  Electricity.  Afper- 
fion  with  cold  water  oil  the  painful  part.  A  bag  of  mow  or  ice 
applied  on  the  pained  part. 

9.  Somnambulifmus.  Sleep-walking  is  a  part  of  reverie,  or 
ftudium  inane,  defcribed  in  Seel:.  XIX.  In  this  malady  the  pa- 
tients have  only  the  general  appearance  of  being  afleep  in  re- 
fpedt  to  their  inattention  to  the  ilimulus  of  external  objects,  but, 
like  the  epilepfies  above  defcribed,  it  confiils  in  voluntary  exer- 
tions to  relieve  pain.  The  mufcles  are  fubfervient  to  the  will, 
as  appears  by  the  patient's  walking  about,  and  fometimes  doing 
the  common  offices  of  life.  The  ideas  of  the  mind  alfo  are  obe- 
dient to  the  will,  becaufe  the  patient's  difcourfe  is  confident, 
though  he  anfwers  imaginary  queftions.  The  irritative  ideas  of 
external  objects  continue  in  this  malady,  becaufe  the  patients  do 
not  run  againft  the  furniture  of  the  room  ;  and  when  they  ap- 
ply their  volition  to  their  organs  of  fenfe,  they  become  tenfible 
of  the  objects  they  attend  to,  but  not  otherwise,  as  general  fen- 
fation  is  deftroyed  by  the  violence  of  their  voluntary  exertions. 
At  the  fame  time  the  fenfations  of  pleafure  in  confequence  of 
ideas  excised  by  volition  are  vividly  experienced,  aad  other 
feem  to  be  excited  by  thefe  pleafurable  lenfations,  as  anpej* 
the  cafe  of  Matter  A.  Sea.  XXXIV.  3.1.  where  a  hiftory  of  a 
hunting  fcene  was  voluntarily  recalled,  wifh  all  the  pleafurable 
ideas  which  attended  it.  In  melancholy  madnefs  the  patient  is 
employed  in  voluntarily  exciting  one  idea,  with  thofe  which  are 
connected  with  it  by  voluntary  aflbciations  only,  but  not  fo  vio- 
lently as  to  exclude  the  ftimuli  of  external  'objects.  In  reverie 
variety  of  ideas  are  occafionaliy  excited  by  volition,  and  tliofe 
which  are  connected  with  the  ~n  Cither  by  fenfitive  or  voluntary 
aiibciations,  and  that  fo  violently  as  to  exclude  the  ftimuli  <: 
ternal  objects.  Thefe  two  fitu.tions  of  cur  fenfuai  motion.?,  or 
ideas,  referable  convulfion  and  -piiepfv  ;  as  in  the  former  the 
ftimulus  of  external  objects  is  ftill  perceiv  lat- 

ter.    Whence  this  dileafe,  fo  far  from  being  connected  with 
fleep,  though  it  has  by  univerfal  miflake  acquired  ifs  name  from 

VOL,  II.  O  o  it,* 


DISEASES  CLASS  III.  1.1.19. 

it,  arifes  from  excels  of  volition,  and  not  from  a  fufpenfion  of  it ; 
and  though,  like  other  kinds  of  epilepfy,  it  often  attacks  the  pa- 
tients in  their  fieep,  yet  thofe  two,  whom  I  faw,  were  more  fre- 
quently feized  with  it  while  awake,  the  fleep-walking  being  a 
part  of  the  reverie.  See  Sett.  XIX.  and  XXXIV.  3.  and  Clafs 

II.  I.  7.  4.  and  III.  I.  2.  1 8. 

M.  M.     Opium  in  large  dofes  before  the  expected  paroxyfm. 

10.  AJlhma  convulflvum.  The  fits  of  convulfive  afthma  return 
at  periods,  and  are  attended  with  cold  extremities,  and  fo  far 
refemble  the  accefs  of  an  intermittent  fever  ;  but,  as  the  lungs 
are  not  fenfible  to  the  pain  of  cold,  a  fhivering  does  not  fuc- 
ceed,  but  inftead  of  it  violent  efforts  of  refpiration  ;  which  have 
no  tendency,  as  in  the  humoral  afthma,  to  diflodge  any  offend- 
ing material,  but  only  to  relieve  the  pain  by  exertion,  like  the 
(huddering  in  the  beginning  of  ague-fits,  as  explained  Clafc. 

III.  I.   I.  2. 

The  infenfibility  of  the  lungs  to  cold  is  obfervable  on  going 
into  frofty  air  from  a  warm  room  j  the  hands  and  face  become 
painfully  cold,  but  no  fuch  fenfation  is  excited  in  the  lungs ; 
which  is  another  argument  in  favour  of  the  exiftence  of  a  peculiar 
fet  of  nerves  for  the  purpofe  of  perceiving  the  univerfal  fluid 
matter  of  heat,  in  which  all  things  are  immerfed.  See  Sect. 
XIV.  6.  Yet  are  the  lungs  neverthelefs  very  fenfible  to  the  de- 
ficiency of  oxygen  in  the  atmofphere,  as  all  people  experience, 
when  they  go  into  a  room  crowded  with  company  and  candles, 
and  complain,  that  it  is  fo  clofe,  they  can  fcarcely  breathe ;  and 
the  fame  in  fome  hot  days  in  fummer. 

There  are  two  difeafes,  which  bear  the  name  of  afthma.  The 
firft  is  the  torpor  or  inability  of  the  minute  vefTels  of  the  lungs, 
confifting  of  the  terminations  of  the  pulmonary  and  bronchial 
arteries  and  veins,  and  their  attendant  lymphatics  ;  in  this  cir- 
cumftance  it  refembles  the  difficulty  of  breathing,  which  attends 
cold  bathing.  If  this  continues  long,  a  congeftion  of  fluid  in 
the  air-cells  fucceeds,  as  the  abforbent  actions  ceafe  completely 
before  the  fecerning  ones  ;  as  explained  in  Clafs  I.  i.  2.  3. 
And  the  coldnefs,  which  attends  the  inaction  of  thefe  vefiels, 
prevents  the  ufual  quantity  of  exhalation*  Some  fits  ceafe  be- 
fore this  congeftion  takes  place,  and  in  them  no  violent  Tweet- 
ing nor  any  expuition  of  phlegm  occurs.  This  is  the  humoral 
afthma,  deicribed  at  Clafs  II.  i.  I.  7. 

The  fecond  kind  of  afthma  confifts  in  the  convulfive  actions 
in  conference  of  the  difagreeable  fenfations  thus  induced  ; 
which  in  fome  fits  of  afthma  are  very  great,  as  appears  in  the 
violent  efforts  to  raife  the  ribs,  and  to  deprefs  the  diaphragm, 
by  lifting  the  (houlders.  Thefe,  fo  long  as  they  contribute  to 

remove 


CLASS  in.  i.  x.  i«.      OF  VOLITION.  291 

remove  the  caufe  of  the  difeafe,  arc  not  properly  convulfions, 
but  exertions  immediately  caufed  by  fenfation ;  but  in  this  kind 
of  afthma  they  are  only  efforts  to  relieve  pain,  and  are  frequent- 
ly preceded  by  other  epileptic  convulfions. 

Thefe  two  kinds  of  afthma  have  fo  many  refembling  features, 
and  are  fo  frequently  intermixed,  that  it  often  requires  great  at- 
tention to  diftinguim  them  ;  but  as  one  of  them  is  allied  to  ana- 
farca,  and  the  other  to  epilepfy,  we  (hall  acquire  a  clearer  idea 
of  them  by  comparing  them  with  thofe  diforders.  A  criterion 
of  the  humoral  or  hydropic  afthma  is,  that  it  is  relieved  by  copi- 
ous fweats  about  the  head  and  breaft,  which  are  to  be  afcribed 
to  the  fenfitive  exertions  of  the  pulmonary  veffels  to  relieve  the 
pain  occafioned  by  the  anafarcous  congeftion  in  the  air-cells  5 
and  which  is  effected  by  the  increafed  abforption  of  the  mucus, 
and  its  elimination  by  the  retrograde  action  of  thofe  lymphatics 
of  the  fkin,  the  branches  of  which  communicate  with  the  pul- 
monary ones ;  and  which  partial  fweats  do  not  eafily  admit  of 
any  other  explanation.  See  Clafs  I.  3.  .2.  8.  Another  criterion 
of  it  is,  that  it  is  generally  attended  with  fwelled  legs,  or  other 
fymptoms  of  anafarca.  A  criterion  of  the  convulfive  afthrrra 
may  be  had  from  the  abfence  of  thefe  cold  clammy  fweats  of  the 
upper  part  of  the  body  only,  and  from  the  patient  having  occa- 
fionally  been  fubject  to  convulfions  of  the  limbs,  as  in  the  com- 
$non  epilepfy. 

It  may  thus  frequently  happen,  that  in  the  humoral  afthma 
fome  exertions  of  the  lungs  may  occur,  which  may  not  contrib- 
ute to  difcharge  the  anafarcous  lymph,  but  may  be  efforts  fimply 
to  relieve  pain  ;  befides  thofe  efforts,  which  produce  the  increaf- 
ed abforption  and  elimination  of  it ;  and  thus  we  have  a  bodily 
difeafe  refembling  in  this  circumftance  the  reverie,  in  which 
both  fenfitive  and  voluntary  motions  are  at  the  fame  time,  or  in 
fucceffion,  excited  for  the  purpofe  of  relieving  pain. 

It  may  likewife  fometimes  happen,  that  the  difagreeable  fen- 
fation, occafioned  by  the  congeftion  of  lymph  in  the  air-cells  in 
the  humoral  or  hydropic  afthma,  may  induce  voluntary  convul- 
fions of  the  refpiratory  organs  only  to  relieve  the  pain,  without 
any  fenfitive  actions  of  the  pulmonary  abforbents  to  abforb  and 
eliminate  the  congeftion  of  ferous  fluid  ;  and  thus  the  fame 
caufe  may  occafionally  induce  either  the  numeral  or  cjjjJR'ulfive 
afthma. 

The  humoral  afthma  has  but  one  remote  caufe,  which  is  the 
torpor  of  the  pulmonary  veffels,  like  that  which  occurs  on  going 
into  the  cold  bath ;  or  the  want  of  abforption  of  the  pulmonary 
lymphatics  to  take  up  the  lymph  effuled  into  the  air-cells. 
Whereas  the  convulfive  afthma,  like  other  convulfions,  or  epi- 

lepfies, 


292  DISEASES  CLASS  III.  i.  i,  io< 

lepfies,  may  be  occafioned  by  pain  in  almoft  any  remote  part  of 
the  fyftem.  But  in  fome  of  the  adult  patients  in  this  difeafe,  as 
in  many  epilepfies,  I  have  fufpecled  the  remote  caufe  to  be  a 
pain  of  the  liver,  or  of  the  biliary  dufts. 

The  afthmas,  which  have  been  induced  in  confequence  of  the 

recefs  of  eruptions,  efpeeially  of  the  leprous  kind,  countenance 

this  opinion.     One  lady  I  knew,  who  for  many  years  laboured 

under  an  ailhma,  which  ceafed  on  her  being  afflicled  with  pain, 

fwelling,  and  diftortion  of  fome  of  her  large  joints,  which  were 

eReemed  gouty,  but  perhaps  erroneously.     And  a  young  man, 

i  I  faw  yefterday,  was  feized  with  afthma  on  the  retrocef- 

or  ceafmg  of  eruptions  on  his  face. 

The  convulfive  all<vr,a,  as  well  as  the  hydropic,  is  more  lia- 
ble to  re  r;  weather  ;  which  may  be  occafioned  by  the 
lefs  quantity  oi  ox  -gen  exifting  in  a  given  quantity  of  warm  air> 
of  cold,  which  can  be  taken  mto  the  lungs  at  one  infpira- 
tion.  They  are  bora  p  oh  liable  to  occur  after  the  firfl  ileep, 
which  is  therefore  a  general  criterion  of  afthma.  The  caufe  of 
this  is  explained  in  Sett.  XVIH-  15.  and  applies  to  both  of 
them,  as  our  feniibility  to  internal  uneafy  fenfation  increaies 
during  fleep. 

When  children  are  gaining  teeth,  long  before  they  appear, 
the  pain  of  the  gums  often  induces  convulfions.  This  pain  is 
relieved  in  fome  by  fobbing  and  fcreaming ;  but  in  others  a  la- 
borious refpiration  is  exerted  to  relieve  the  pain  j  and  this  con- 
ilitute*  the  true  afthma  convulfivum.  In  other  children  again 
general  convulfions,  or  epileptic  paroxyfms,  are  induced  for  this 
purpofe  j  which,  like  other  epilepfies,  become  eftablifhed  by 
Iiabit,  and  recur  before  the  irritation  has  time  to  produce  the 
painful  fenfation,  which  originally  caufed  them. 

The  afthma  convulfivum  is  alfo  fometimes  induced  by  worms, 
or  by  acidity  in  the  ftomachs  of  children,  and  by  other  painful 
fenfations  in  aduhs  j  in  whom  it  is  generally  called  nervous 
aiihma,  and  is  often  joined  with  other  epileptic  fymptoms. 

This  ailhma  is  diftinguifted  from  the  peripneumony,  and 
from  the  croup,  by  the  prefence  of  fever  in  the  two  latter.  It 
is  diftinguiflied  from  the  humoral  afthma,  as  in  that  the  patients 
are  more  liable  to  run  to  the  cold  air  for  relief,  are  more  fubjeft 
to  cold  extremities,  and  experience  the  returns  of  it  more  fre- 
quently after  their  fuft  fleep.  \It  is  diftinguiflied  from  the  hy- 
drops  thoracis,  as  that  has  no  intervals,  and  the  patient  fits  con- 
iiantly  upright,  and  the  breath  is  colder  ;  and,  where  the  peri- 
cardium is  affected,  the  pulfe  is  quick  and  unequal.  See  Hy- 
drops  Thoracis,  I.  2.  3.  14. 

M.  M.    Venfec~Uon  once.     A  cathartic  with  calomel  once.. 

Opium. 


CLASS  III.  i .  i .  1 1 .      OF  VOLITION.  293 

Opium.  Afafcetida.  Warm  bath.  If  the  caufe  can  be  detect- 
ed, as  in  toothing  or  worms,  it  (hould  be  removed.  As  this 
fpecies  of  afthma  is  fo  liable  to  recur  during  ileep,  like  epileptic 
fits,  as  mentioned  in  Section  XVIII.  15.  there  was  reafon  to  be- 
lieve, that  the  refpiration  of  an  atmofphere  mixed  with  hydro- 
gen, or  any  other  innocuous  air,  which  might  dilute  the  oxygen, 
would  be  ufeful  in  preventing  the  paroxyfms  by  decreafing  the 
fenfibility  of  the  fyftem.  This,  I  am  informed  by  Dr.  Beddoes, 
has  been  ufed  with  decided  fuccefs  by  Dr.  Perriar.  See  Clafs 
II.  i.  i.  7. 

n.  AJlhma  dohrificum.  Angina  pe<^oris.  The  painful 
afthma  was  firft  defcribed  by  Dr.  Heberden  in  the  Tranfaclions 
of  the  College  ;  its  principal  fymptoms  confift  in  a  pain  about 
the  middle  of  the  fternum,  or  rather  lower,  on  every  increafe  of 
pulmonary  or  mufcular  exertion,  as  in  walking  fafter  than  ufual, 
or  going  quick  up  a  hill,  or  even  up  flairs  ;  with  great  difficul- 
ty of  breathing,  fo  as  t&  occafion  the  patient  inftantly  to  ftop. 
A  pain  in  the  arms  about  the  infertion  of  the  tendon  of  the  pec- 
toral mufcle  generally  attends,  and  a  defire  of  refting  by  hang- 
ing on  a  door  or  branch  of  a  tree  by  the  arms  is  fometimes  ob- 
ferved.  Which  is  explained  in  Clafs  I.  2.  3.  14.  and  in  Seel. 
XXIX.  5.  2. 

Thefe  patients  generally  die  fuddenly ;  and  on  examining  the 
thorax  no  certain  caufe,  or  feat,  of  the  difeafe  has  been  detect- 
ed •,  fome  have  fuppofed  the  valves  of  the  arteries,  or  of  the 
heart,  were  imperfect ;  and  others  that  the  accumulation  of  fat 
about  this  vifcus  or  the  lungs  obftrutted  their  due  action  ;  but 
other  obfervations  do  not  accord  with  thefe  fuppofitions. 

Mr.  W ,  an  elderly  gentleman,  was  feized  with  afthma 

during  the  hot  part  of  laft  fummer  ;  he  always  waked  from  his 
firft  fleep  with  difficult  refpiration,  and  pain  in  the  middle  of 
his  fternum,  and  after  about  an  hour  was  enabled  to  fleep  again. 
As  this  had  returned  for  about  a  fortnight,  it  appeared  to  me  to 
be  an  afthma  complicated  with  the  difeafe,  which  Dr.  Heberden 
has  called  angina  pecloris.  It  was  treated  by  venefe&ion,  a  ca- 
thartic, and  then  by  a  grain  of  opium  given  at  going  to  bed,  with 
ether  and  tincture  of  opium  when  the  pain  or  afthma  recurred, 
and  laftly  with  the  bark,  but  was  feveral  days  before  it  was  per- 
fectly fubdued. 

This  led  me  to  conceive,  that  in  this  painful  afthma  the  dia- 
phragm, as  well  as  the  other  mufcles  of  reipiration,  was  thrown 
into  convuliive  action,  and  that  the  fibres  of  this  mufcle  not  hav- 
ing proper  antagonifts,  a  painful  fixed  fpafm  of  it,  like  that  of 
the  mufcles  in  the  calf  of  the  leg  in  the  cramp,  might  be  the 
caufe  of  death  in  the  angina  pectoris,  which  I  have  thence  ar- 
ranged 


294  DISEASES  CLASS  III.  i .  i .  1 1 . 

ranged  under  the  name  of  painful  afthma,  and  leave  for  further 
investigation. 

From  the  hiftory  of  the  cafe  of  the  late  much  lamented  John 
Hunter,  and  from  the  appearances  after  death,  the  cafe  feems  to 
have  been  of  this  kind,  complicated  with  vertigo  and  confequent 
affection  of  the  ftomach.  The  remote  caufe  feems  to  have  arifen 
from  offifications  of  the  coronary  arteries  ;  and  the  immediate 
caufe  of  his  death  from  fixed  fpafm  of  the  heart.  Other  hifto- 
ries  and  directions  are  ftill  required  to  put  this  matter  out  of 
doubt  ;  as  it  is  poffible,  that  either  a  fixed  fpafm  of  the  dia- 
phragm, or  of  the  heart,  which  are  both  furnifhed  with  but 
weak  antagonifts,  may  occafion  fudden  death  ;  and  thefe  may 
conftitute  two  diitinct  difeafes. 

Four  patients  I  have  now  in  my  recollection,  all  of  whom  I 
believed  to  labour  under  the  angina  pectoris  in  a  great  degree  j 
which  have  all  recovered,  and  have  continued  well  three  or  four 
years  by  the  ufe,  as  I  believe,  of  iffues  on  the  infide  of  each 
thigh ;  which  were  at  firft  large  enough  to  contain  two  peafe 
each,  and  afterwards  but  one.  They  took  befides  fome  flight 
antimonial  medicine  for  a  while,  and  were  reduced  to  half  the 
quantity  or  ftrength  of  their  ufual  potation  of  fermented  liquor. 

The  ufe  of  femoral  iflues  in  angina  pectoris  was  firft  recom- 
mended by  Dr.  Macbride,  phyfician  at  Dublin,  Med.  Obferv. 
and  Enquir.  Vol.  VI.  And  I  was  further  induced  to  make  trial 
of  them,  not  only  becaufe  the  means  which  I  had  before  ufed 
were  inadequate,  but  from  the  ill  effect  I  once  obferved  upon 
the  lungs,  which  fucceeded  the  cure  of  a  fmall  fore  beneath  the 
knee ;  and  argued  converfely,  that  iffues  in  the  lower  limbs 
might  affift  a  difficult  refpiration. 

Mrs.  L ,  about  fifty,  had  a  fmall  fore  place,  about  the  fize 

of  half  a  pea  on  the  infide  of  the  leg  a  little  below  the  knee.  It 
had  difcharged  a  pellucid  fluid,  which  (lie  called  a  ley-water, 
daily  for  fourteen  years,  with  a  great  deal  of  pain  y  on  which 
account  fhe  applied  to  a  furgeon,  who,  by  means  of  bandage  and 
a  faturnine  application,  foon  healed  the  fore,  unheedful  of  the 
confequences.  In  lefs  than  two  months  after  this  I  faw  her  with 
great  difficulty  of  breathing,  which  with  univerfal  anafarca  foon 
deftroyed  her. 

The  theory  of  the  double  effect  of  iffues,  as  above  related, 
one  in  relieving  by  their  prefcnce  the  afthma  dolorificum,  and 
the  other  in  producing  by  its  cure  an  anafarca  of  the  lungs,  is 
not  eafy  to  explain.  Some  fimilar  effects  from  cutaneous  erup- 
tions and  from  bliiters  are  mentioned  in  Clafs  I.  1.2.  9.  In 
thefe  cafes  it  feems  probable,  that  the  pain  occafioned  by  iffues, 
and  perhaps  the  abforption  of  a  fmall  quantity  of  aerated  puru- 
lent 


CLASS  III.  i.  1. 12.        OF  VOLITION.  205 

lent  matter,  ftimulate  the  whole  fyftem  into  greater  energy  of 
aclion,  and  thus  prevent  the  torpor  which  is  the  beginning  of 
fo  many  difeafes.  In  confirmation  of  this  effect  of  pain  on  the 
fyftem,  I  remember  the  cafe  of  a  lady  of  an  ingenious  and  ac- 
tive mind,  who,  for  many  of  the  latter  years  of  her  life,  was 
perpetually  fubjecl;  to  great  pains  of  her  head  from  decaying 
teeth.  When  all  her  teeth  were  gone,  (he  became  quite  low 
fpirited,  and  melancholy  in  the  popular  fenfe  of  that  word,  and 
after  a  year  or  two  became  univerfally  dropfical  and  died. 

M.  M.  Iflues  in  the  thighs.  Five  grains  of  rhubarb,  and  an* 
fixth  of  a  grain' of  emetic  tartar  every  night  for  fome  months, 
with  or  without  half  a  grain  of  opium.  No  ftronger  liquor 
than  fmall  beer  or  wine  diluted  with  twice  its  quantity  of  water. 
Since  I  wrote  the  above  I  have  feen  two  cafes  of  hydrops  tho- 
racis  attended  with  pain  in  the  left  arm,  fo  as  to  be  miftakpi 
for  afthma  dolorificum,  in  which  femoral  iflues,  though  applied 
early  in  the  difeafe,  had  no  ef&cl. 

12.  Stridor  dentium.     The  clattering  of  the  teeth  ongoing 
into  cold  water,  or  in  the  beginning  of  ague-fits,  is  an  exertion 
along  with  the  tremblings  of  the  (kin  to  relieve  the  pain  of  cold. 
The  teeth  and  fkin  being  more  fenfible  to  cold  than  the   more 
internal  parts,  and  more   expofed  to  it,  is  the  reafon  that  the 
mufcles  which   ferve  them,  are  thrown  into  exertion  from  the 
pain  of  cold  rather  than  thofe  of  refpiration,  as  in  fcreaming 
from  more  acute  pain.     Thus  the  poet, 

Put  but  your  toes  into  cold  water, 
Your  correfpondent  teeth  will  clatter. 

PRIOR. 

In  more  acute  pains  the  jaws  are  gnaflied  together  witli  great 
vehemence,  infomuch  that  fometimes  the  teeth  are  faid  to  have 
been  broken  by  the  force.  See  Sett.  XXXIV.  1.3.  In  thefe 
cafes  fomething  mould  be  offered  to  the  patient  to  bite,  as  a 
towel,  otherwife  they  are  liable  to  tear  their  own  arms,  or  to 
bite  their  attendants,  as  I  have  witnefled  in  the  painful  epi- 
lepfy. 

1 3.  Tetanus  trifmus.     Cramp.     The  tetanus  confifts  of  a  fix- 
ed fpafm  of  almoft  all  the  mufcles  of  the  body  ;  but  the  trifmus, 
or  locked  jaw,  is  the  moft  frequent  difeafe  <jf  this  kind.     It  is 
generally  believed  to  arife  from  fympathy  with  an  injured  ten- 
don.    In  one  cafe  where  it  occurred  in  confequence  of  a  broken 
ancle  from  a  fall  from  a  horfe,  it  was  preceded  by  evident  hy- 
drophobia.    Amputation   was   advifed   but   not   fubmittcd  to ; 
two  wounds  were  hid  into  one  with  fciflbrs,  but  the  patient  di- 
*-d  about  the  feventh   day  from  the  accident.     In   this  cafe  the 

wounded 


296  DISEASES  CLASS  in.  i,  i,  14. 

wounded  tendon,  like  the  wounds  from  the  bite  of  a  mad  dog, 
did  not  produce  the  hydrophobia,  and  then  the  locked  jaw,  till 
feveral  days  after  the  accident. 

I  twice  witnefTed  the  locked  jaw  from  a  pain  beneath  the 
flernum,  about  the  part  where  it  is  complained  of  in  painful 
afthma,  or  angina  pe&oris,  in  the  fame  lady  at  fome  years  dif- 
tance  of  time.  The  laft  time  it  had  continued  two  days,  and 
{he  wrote  her  mind,  or  expreffed  herfelf  by  figns.  On  obferv- 
ing  a  broken  tooth,  which  made  a  fmall  aperture  into  her  mouth, 
I  rolled  up  five  grains  of  opium  like  a  worm  about  an  inch  long, 
and  introducing  it  over  the  broken  tooth,  pufned  it  onward  by 
means  of  a  fmall  crow-quill  *,  as  it  diiTolved  I  obferved  (he  fwal- 
lowed  her  faliva,  and  in  lefs  than  half  an  hour  flie  opened  her 
mouth  and  converfed  as  ufual. 

Men  are  taught  to  be  afhamed  of  fcreaming  from  pain  in 
their  early  years  j  hence  they  are  prone  to  exert  the  mufcles  of 
the  jaws  inftead,  which  they  have  learnt  to  exert  frequently  and 
violently  from  their  infancy  ;  whence  the  locked  jaw.  This 
and  the  following  fpafm  have  no  alternative  relaxations,  like  the 
preceding  ones ;  which  is  perhaps  owing,  firit,  to  the  weaknefs 
of  their  antagoniil  mufcles,  thofe  which  elevate  the  jaw  being 
very  ftrong  for  the  parpoie  of  biting  and  mafticating  hard  fub- 
ftances,  and  for  fupporting  the  under  jaw,  with  very  weak  an- 
tagonift  mufcles ;  and  fecondly,  to  their  not  giving  fufficient  re- 
lief even  for  a  moment  to  the  pain,  or  its  preceding  irritation, 
which  excited  them. 

M.  M.  Opium  in  very  large  quantities.  Mercurial  oint- 
ment ufed  extenfively.  Electricity.  Cold  bath.  Dilate  the 
wound,  and  fill  it  with  lint  moiltened  with  fpirit  of  turpen- 
tine ;  which  inflames  the  wound,  and  cures  or  prevents  the  con-* 
vultions.  See  a  cafe,  Tranfacl.  of  American  Society,  Vol.  II. 
p.  227. 

Wine  in  large  quantities  in  one  cafe  was  more  fuccefsful 
than  opium  ;  it  probably  inflames  more,  which  in  this  difeafe 
is  defirable.  Between  two  or  three  ounces  of  bark,  and  from 
a  quart  to  three  pints  of  wine  a  day,  fucceeded  better  than  opi- 
um. Ib. 

14.  Tetanus  dolorifctis.  Painful  cramp.  This  kind  of  fpafm 
moft  frequently  attacks  the  calf  of  the  leg,  or  mufcles  of  the 
toes  ;  it  often  precedes  paroxyfms  of  gout,  and  appears  towards 
thv  end  of  violent  diarrhoea,  and  from  indigeflion,  or  from  acid 
di .  c.  In  thefe  cafef  it  feems  to  fympathize  with  the  bowels,  but 
is  aifo  frequently  produced  by  the  pain  of  external  cold,  and  by 
tl  j  too  gr«at  previous  extension  of  the  mufcles,  whence  fome 
people  get  the  cramp  in  the  extenfor  mufrle*  of  the  toes  after 

w  al  kin  2 


CLASS  III.  t.  1. 15.        OF  VOLITION,  297 

walking  down  hill,  and  of  thofe  of  the  calf  of  the  leg  after  walk- 
ing up  a  deep  eminence.  For  the  reafon  why  thefe  cramps 
commence  in  fleep,  fee  Sect.  XVIII,  15. 

The  mufcle  in  this  difeafe  contracts  itfelf  to  relieve  fome 
fmaller  pain,  either  from  irritation  or  aflbciation,  and  then  falls 
into  great  pain  itfelf,  from  the  too  great  action  of  its  own  fibres. 
Hence  any  mufcle,  by  being  too  vehemently  exerted,  falls  into 
cramp,  as  in  fwimming  too  forcibly  in  water,  which  is  painfully 
cold  ;  and  a  fecondary  pain  is  then  induced  by  the  too  violent 
contraction  of  the  mufcle  ;  though  the  pain,  which  was  the 
caufe  of  the  contraction,  ceafes.  Which  accounts  for  the  con- 
tinuance of  the  contraction,  and  diftinguimes  this  difeafe  from 
other  convulfions,  which  are  relaxed  and  exerted  alternately. 
Hence  whatever  may  be  the  caufe  of  the  primary  pain,  which 
occafions  the  cramp  of  the  calf  of  the  leg,  the  fecondary  one  is 
relievable  by  ftanding  up,  and  thus  by  the  weight  of  the  body 
on  the  toes  forcibly  extending  the  contracted  mufcles.  For  the 
caufe  which  induces  thefe  mufcles  of  the  calf  of  the  leg  to  fall 
into  more  violent  contraction  than  other  fpafmodic  mufcles, 
proceeds  from  the  weaknefs  of  their  antagonift  mufcles ;  as 
they  are  generally  extended  again  after  action  by  the  weight 
of  the  body  on  the  balls  of  the  toes.  See  the  preceding  article. 

M.  M.  Rub  the  legs  with  camphor  diflblved  in  oil,  and  let 
the  patient  wear  (lockings  in  bed.  If  a  foot-board  be  put  at 
the  bed's  feet,  and  the  bed  be  fo  inclined,  that  he  will  reft  a 
little  with  his  toes  againft  the  foot-board,  that  preflure  is  faid 
to  prevent  the  undue  contractions  of  the  mufculi  gaftrocnemii, 
which  conftitute  the  calf  of  the  leg.  In  gouty  patients,  or 
where  the  bowels  are  affected  v/ith  acidity,  half  a  grain  of  opi- 
um, and  fix  grains  of  rhubarb,  and  fix  of  chalk,  every  night. 
FlenVmeat  for  fupper.  A  little  very  weak  warm  fpirit  and 
water  may  be  taken  for  prefent  relief,  when  thefe  cramps  are 
very  troubleforrte  to  weak  or  gouty  patients. 

15.  Hydrophobia.  Dread  of  water  generally  attending  ca- 
nine madnefs.  I  was  witnefs  to  a  cafe,  wheje  this  difeafe  pre- 
ceded the  locked  jaw  from  a  wound  in  the  ancle,  occafioned  by 
a  fall  from  a  horfe  ;  as  mentioned  in  the  preceding  article.  It 
came  on  about  the  fixth  day  after  the  accident ;  when  the  pa- 
tient attempted  to  fwallow  fluids,  he  became  convulfed  all 
over  from  the  pain  of  this  attempt,  and  fpurted  them  out  of  his 
mouth  with  violence.  It  is  alfo  faid  to  happen  in  fome  hyfterical 
cafes.  Hence  it  feems  rather  the  immediate  confcquence  of  % 
pained  tendon,  than  of  a  contagious  poifon.  And  is  fo  far  anal- 
ogous to  tetanus,  according  with  the  opinions  of  Dr.  Rulh  and 
Dr.  Percival. 

VOL.  II.  P  t  In 


*9*  DISEASES  CLASS  III.  1.1.15. 

In  other  ?efpe£h,  as  it  is  produced  by  the  faliva  of  an  enrag- 
ed animal  inftilled  into  a  wound,  it  would  feem  analogous  to 
the  pbifon  of  venomous  animals.  And  from  the  manner  of  its  ac- 
cefs  fo  long  after  the  bite,  and  of  its  termination  in  a  fhort  time, 
it  would  feem  to  refemble  the  progrefs  of  contagious  fevers. 
SeeSea.  XXir.  3.  3. 

If  the  patient  was  bitten  in  a  part,  which  could  be  totally  cut 
away,  as  a  finger,  even  after  the  hydrophobia  appears,  it  is  prob- 
able it  might  cure  it ;  as  I  fufpeft  the  caufe"  ftill  remains  in  the 
Bounded  tendon,  and  not  in  a  difFufed  infection  tainting  the 
blood.  Hence  there  are  generally  uneafy  fenfations,  as  cold  of 
numbnefs,  in  the  old  cicatrix,  before  the  hydrophobia  commenc-* 
£s.  See  a  cafe  in  Medical  Communications,  Vol.  II.  p.  190. 

If  the  difeafed  tendon  could  be  inflamed  without  cutting  it 
out,  as  by  cupping,  or  cauflic,  or  Hitter  after  cupping,  and  this 
m  the  old  wound  long  fmce  healed,  after  the  hydrophobia  com- 
mences, it  might  prevent  the  fpafms  about  the  throat.  As  in- 
flaming the  teeth  by  the  ufe  of  mercury  is  of  ufe  in  fome  kinds 
of  hemkrania,  Put  fpirit  of  turpentine  on  the  wound,  walh  it 
well.  See  Clafs  I.  3.  i.  1 1.  IV.  r .  2.  7. 

M.  M.  Wine,  mufk,  oil,  internally.  Opium,  mercurial  oint- 
ment, ufed  extenfively.  Mercurial  fumigation.  Turpeth  min- 
eral. To  falivate  the  patient  as  foon  as  poflible.  Exfe&ion  or 
;i  cauflic  on  the  fear,  even  after  the  appearance  of  hydrophobia. 
Put  a  tight  bandage  on  the  limb  above  the  fear  of  the  old  wound 
to  benumb  the  pained  tendon,  however  long  the  wound  may 
have  been  healed.  Could  a  hollow  catheter  of  elaflic  gum,  ca- 
outchouc, be  introduced  into  the  cefophagus  by  the  mouth  or 
noftril,  and  liquid  nourifhment  be  thus  conveyed  into  the  flom* 
ach  ?  See  Default's  Journal,  Cafe  I.  where  in  an  ulcer  of  the 
mouth,  fuch  a  catheter  was  introduced  by  the  noftril,  and  kept 
in  the  oefophagus  for  a  month,  by  which  means  the  patient  was 
nourifhed  and  preferved. 

It  is  recommended  by  Dr.  Bardfley  to  give  oil  internally  by  a 
fimilar  method  contrived  by  Mr.  John  Hunter.  He  covered  a 
probang  with  the  ilcin  of  a  tmall  eel,  or  the  gut  of  a  lamb  or  cat. 
It  was  tied  up  at  one  end  above  and  below  the  fponge,  and  a  flit 
made  above  the  upper  ligature  ;  to  the  other  end  of  the  eel  fkin 
or  gut  was  fixed  a  bladder  and  pipe.  The  probang  thus  cover- 
ed was  introduced  into  the  flomach,  and  the  liquid  food  or  med- 
icine was  put  into  the  bladder  and  fqueezed  down  through  the 
cel-lkin.  Mem.  of  Society  at  Manchester.  See  Clafs  I.  2.  3.  25. 

Dr.  Bardfley  has  endeavoured  to  prove,  that  dogs  never  ex- 
perience  the   hydrophobia,  or  canine  madnefs,   without  having 
;ireviouily  bitten  or  infected ;  and  fecondly,  that  the  dif- 

eafa 


CLASS  III.  1. 1.  15.      OF  VOLITION.  299 

cafe  in  this  fpecies  of  animal  always  £hews  itfelf  in  five  or  fix 
weeks ;  and  concludes  from  hence,  that  this  dreadful  mahdy 
might  be  annihilated  by  making  all  the  dogs  in  Great  Britain 
perform  a  kind  of  quarantine,  by  fhutting  them  up  for  a  certain 
number  of  weeks.  Though  the  difeafe  from  the  bite  of  the  mad 
dog  is  perhaps  more  analogous  to  thofe  from  the  wounds  inflict- 
ed by  venomous  animals  than  to  thofe  from  other  contagious 
matter,  yet  thefe  dbfervations  are  well  worthy  further  atten- 
tion ;  which  the  author  promifes. 

In  Dr,  Hamilton's  elaborate  treatjfe  on  hydrophobia,  Long- 
man, London,  it  is  propofed  to  try  the  effedT:  of  arfenic  in  this  dii- 
eafe,  which  is  faid  to  be  the  principal  ingredient  of  the  TVinjore 
pill,  which  is  faid  to  cure  thofe  who  are  difeafed  by  the  bite  of 
ferpents,  and  to  cure  the  hydrophobia, 

A  folution  of  fublimate  of  mercury  in  rectified  fpirits  is 
worthy  a  trial,  as  mentioned  in  CJafs  I.  3.  i.  i 1. 


ORDO 


DISEASES  CLASS  III.  i.  a, 

ORDO   I. 

fncreafed    Volition. 

GENUS  II. 
With  incrtftfed  AB'tons  of  the  Organs  of  Senfe. 

IN  every  fpecies  of  madnefs  there  is  a  peculiar  idea  either  of 
defire  or  averfion,  which  is  perpetually  excited  in  the  min4  with 
ill  its  connections.  In  fome  conftitutions  this  is  connected  with 
pleafurable  ideas  without  the  exertion  of  much  mufcular  action, 
in  others  it  produces  violent  mufcular  action  to  gain  or  avoid  the 
object  of  it,  in  others  it  is  attended  with  defpair  and  inaction. 
Mania  is  the  general  word  for  the  two  former  of  thefe,  and 
melancholia  for  the  latter  ;  but  the  fpecies  of  them  are  as  nu- 
merous as  the  ^efires  and  averfions  of  mankind. 

In  the  prefent  age  the  pleafurable  infanities  are  moft  fre- 
quently induced  by  fuperftitious  hopes  of  K[eaven,  by  fentimen- 
tal  love,  and  by  perfonal  vanity.  The  furious  infanities  by 
pride,  anger,  revenge,  fufpicion.y  And  the  melancholy  ones  by 
fear  of  poverty,  fear  of  death,  arid  fear  of  Hell  ;  with  innumer- 
able others. 

Quicquid  agunt  homines,  votum,  timqr,  ira,  voluptas, 
Gaudia,  difcurfus,  noftri  eft  farrago  libftlli. 

JUVEN.  I.  85. 

This  idea,  however,  which  induces  madnefs  or  melancholy, 
is  generally  untrue  ;  that  is,  the  objecl:  is  a  miftaken  fact.  As 
when  a  patient  is  perfuaded  he  has  the  itch,  or  venereal  difeafe, 
of  which  he  has  no  fymprtom,  and  becomes  mad  from  the  pain 
this  idea  occafions.  So  that  the  objecl:  of  madnefs  is  generally 
a  delirious  idea,  and  thence  cannot  be  conquered  by  reafon  ;  be- 
caufe  it  continues  to  be  excited  by  painful  fenfation,  which  is  a 
ilrongcr  ftimulus  than  volition.  Moft  frequently  pain  of  body 
is  the  caufe  of  convulfion,  which  is  often  however  exchanged  for 
madnefs  j  and  a  painful  delirious  idea  is  moft  frequently  the 
caufe  of  madnefs  originally,  but  fometimes  of  convulfiou.  Thus 
I  have  feeri  a  young  lady  become  convulfed  from  a  fright,  and 
die  in  a  few  days  ;  and  a  temporary  madnefs  frequently  termin- 
ates the  paroxyfms  of  the  epilepfia  dolorifica,  and  an  infanity  of 
greater  permanence  is  frequently  induced  by  the  pains  or  bruif- 
es  of  parturition. 

Where  the  patient  is  debilitated  a  quick  pulfe  fometimes  at- 
tends 


CLASS  III.  i.  2.  OF  VOLITION.  3ct 

tends  infane  people,  which  is  neverthelefs  generally  only  a  fymp- 
tom  of  the  debility  owing  to  the  too  great  expenditure  of  fenfo- 
rial  power  ;  or  of  the  paucity  of  its  production,  as  in  irritative, 
or  infenfitive  inirritated  fever.  See  Clafs  III.  i.  i. 

But  neverthelefs  where  the  quick  pulfe  is  permanent,  it  flhewg 
the  prefence  of  fever  ;  and  as  the  madnefs  then  generally  arifes 
from  the  difagreeable  fenfations  attending  the  fever,  it  is  fo  far 
a  good  fymptom ;  becaufe  when  the  fever  is  cured,  or  ceafes 
fpontaneoufly,  the  infanity  molt  frequently  vaniihes  at  the  fame 
time. 

The  ftimulus  of  fo  much  volition  fupports  infane  people  un- 
der variety  of  hardihips,  and  contributes  to  the  cure  of  diieafes 
from  debility,  as  fometimes  occurs  towards  the  end  of  fevers. 
See  Seel:.  XXXIV*  2.  5.  And,  on  the  fame  account,  they  bear 
Jargc  dofes  of  medicines  to  procure  any  operation  on  them  ;  as 
emetics,  and  cathartics,  which,  before  they  produce  their  effect 
in  inverting  die  motions  of  the  flomach  in  vomiting-,  or  of  the 
abibrbents  of  the  bowels  in  purging,  muft  firft  weaken  the  natur- 
^1  actions  of  thofe  organs,  as  (hewn  in  Sect.  XXXV.  1.13. 

From  thefe  confiderations  it  appears,  that  the  indications  of 
pure  muft  confift  in  removing  the  caufe  of  the  pain,  whether  it 
arifes  from  a  delirious  idea,  or  from  a  real  fact,  or  from  bodily 
difeafe  -9  or  fecondly,  if  this  cannot  be  done,  by  relieving  the 
pain  in  confequence  of  fuch  idea  or  difeafe.  The  firit  is  fome- 
times effected  by  preferring  frequently  in  a  day  contrary  ideas 
to  (hew  the  fallacy,  or  the  too  great  eftimation,  of  the  painful 
ideas,  adly.  By  change  of  place,  and  thus  prefenting  the  itim- 
iilus  of  new  objects,  as  a  long  journey,  sdly.  By  producing 
forgetfulnefs  of  the  idea  or  object,  which  caufes  their  pain  •,  by 
removing  all  things  which  recal  it  to  their  minds  ;  and  avoiding 
all  converfation  on  fimilar  fubjects.  For  I  fuppofe  no  difeafe 
of  the  mind  is  fo  perfectly  cured  by  other  means  as  by  forget- 
fulnefs. 

Secondly,  the  pain  in  confequence  of  the  ideas  or  bodily  dif- 
eafes  above  defcribed  is  to  be  removed,  firft,  by  evacuations,  as 
venefection,  emetics,  and  cathartics  -,  and  then  by  large  dofes 
of  opi^m,  or  by  the  vertigo  occafioned  by  a  circulating  fwing,  or 
by  a  fea-voyage,  which,  as  they  affect  the  organs  of  fenfe  as  well 
as  evacuate  the  ftomach,  may  contribute  to  anfwer  both  indica- 
tions of  cure. 

Where  maniacs  are  outrageous,  there  can  be  no  d£ubt  but  co- 
ercion is  neceffary  ;  which  may  be  done  by  means  of  a  f trait 
waiftcoat  ;  which  difarms  them  without  hurting  them  ;  and  by 
tying  a  handkerchief  round  their  ankles  to  prevent  their  efcape. 
la  others  there  can  be  no  doubt,  but  that  confinement  retards 

rather 


3«*  DISEASES  CLASS  III.  ^. 

rather  than  promotes  their  cure ;  which  is  forwarded  by  change 
of  ideas  in  confequence  of  change  of  place  and  of  objects,  as  by 
travelling  or. failing. 

The  circumftances  which  render  confinement  necefiary,  are 
firft,  if  the  lunatic  is  liable  to  injure  others,  which  muft  be  judg« 
ed  of  by  the  outrage  he  has  already  committed.  2dly,  If  he  is 
likely  to  injure  himfelf ;  this  alfo  muft  be  judged  of  by  the  def- 
pondency  of  his  mind,  if  fuch  exift s.  3dly.  If  he  cannot  take 
care  of  his  affairs.  Where  none  of  thefe  circumftances  exift, 
there  fhould  be  no  confinement.  For  though  the  miftaken  idea 
continues  to  exift,  yet  if  no  actions  are  produced  in  eonfequence 
of  it,  the  patient  cannot  be  called  infane.  He  can  only  be  tern> 
ed  delirious.  If  every  erne,  who  poflefles  miftaken  ideas,  or  who 
puts  falfe  eftimates  on  things,  was  liable  to  confinement,  I  know 
not  who  of  my  readers  might  not  tremble  at  the  fight  of  a  mad- 
houfe  ! 

The  moft  convenient  diftribution  of  infanities  will  be  into 
general,  as  mania  mutabilis,  ftudium  inane,  and  vigilia  $  and 
into  partial  infanities.  Thefe  laft  again  may  be  fubdivided  into 
defires  and  averfions,  many  of  which  are  fucceeded  by  pleafura- 
ble  or  painful  ideas,  by  fury  or  dejection,  according  to  the  de- 
gree or  violence  of  their  exertions.  Hence  the  analogy  between 
the  infanities  of  the  mind,  and  the  convulfions  of  the  mufeles 
defcribed  in  the  preceding  genus,  is  curioufly  exact.  The  con- 
vulfions  without  ftupor,  are  either  juft  fufficient  to  obliterate  the 
pain,  which  occafions  them  5  or  are  fucceeded  by  greater  pain, 
as  in  the  convulfio  dolorifica.  So  the  exertions  in  the  mania 
mutabilis  are  either  juft  fufficient  to  allay  the  pain  which  occa« 
(ions  them,  and  the  patient  dwells  comparatively  in  a  cjuiefc 
{late  j  or  thofe  exertions  excite  painful  ideas,  which  are  fucceed- 
ed by  furious  difcourfes,  or  outrageous  actions.  The  ftudium 
inane,  or  reverie,  refembles  epilepfy,  in  which  there  is  no  fenfi- 
bility  to  the  ftirnuli  of  external  objects.  Vigilia,  or  watchful* 
nefs,  may  be  compared  to  the  general  writhing  of  the  body  ; 
which  is  juft  a  fufficient  exertion  to  relieve  the  pain  which  occa- 
fions it.  Erotomania  may  be  compared  to  trifmus,  or  other  muf- 
cular  fixed  fpafrn,  without  much  fubfequent  pain  •,  and  mceror 
to  cramp  of  the  mufcles  of  the  leg,  or  other  fixed  fpafm  with 
fubfequent  pain.  All  thefe  coincidences  contribute  to  mew,  as 
explained  in  Sect.  III.  5,  that  our  ideas  are  motions  of  the  im- 
mediate organs  of  fenfe  obeying  the  fame  laws  as  our  mufcular 
motions. 

The  violence  of  action  accompanying  infanity  depends  much 
on  the  education  of  the  perfon  ;  thofe  who  have  been  proudly 
educated  with  unreftrained  paflionsj  are  liable  to  greater  fury  ; 


CLASS  III.  i.  a.  OF  VOLITION,  303 

and  thofe,  whofe  education  has  been  humble,  to  greater  defpqn* 
dency*  Where  the  delirious  idea,  above  defcribed,  produces 
pleafurable  fenfations,  as  in  perfonal  vanity  or  religious  enthufi- 
afm  ;  it  is  almoft  a  pity  to  match  them  from  their  fool's  para- 
dife,  and  reduce  them  again  to  the  common  lot  of  humanity  ; 
left  they  (hould  complain  of  their  cure,  like  the  patient  deforib- 
ed  in  Horace, 

»*.•»• •  Pol  i  me  occidiftia,  amid, 

Non  fervaftis,  ait,  cui  fie  extorta  voluptas, 
Et  dcmptus  per  vim  mentis  gratiflimus  error ! 

As  infanities  arife  from  excefs  of  actjon  of  the  fenforial  pow* 
nr  of  volition,  this  excefs  of  action  may  be  owing  either  to  the 
increafe  of  motive  or  ftimulus,  or  to  an  increafed  quantity  or 
accumulation  of  that  fenforial  power.  And  hence,  though  the 
greateft  number  of  infanities  originate  from  increafed  motive  to 
voluntary  action,  as  to  avoid  pain  or  to  acquire  pleafure  j  yet 
there  appear  to  be  fome,  which  have  for  their  caufe  an  accumu- 
lation of  the  fenforial  power  of  volition. 

Thus  thofe,  who  have  been  accuilomed  to  perpetual  exer- 
tions of  volition  in  carrying  on  fome  extenfive  employment  or 
profeflion  during  the  firft  half  of  their  lives,  are  liable  to  be- 
come melancholy,  and  eren  to  deftroy  themfelves,  if  they  fud- 
denly  leave  off  their  very  active  and  anxious  exertions,  and  re- 
tire to  a  fituation  without  employment,  of  which  many  inftances 
have  occurred.  This  feems  to  originate  from  the  pain  occafion* 
ed  by  the  accumulation  of  the  fenforial  power  of  volition,  which 
now  ceafes  to  be  expended  for  want  of  motive.  The  tsedium 
vitse  defcribed  in  No.  X.  of  this  genus  of  difeafes  affects  indo» 
lent  people,  who  poffefs  accumulated  fenforial  power,  but  want 
motive  to  excite  it  into  fuch  actions  of  the  mufcles  or  ideas,  as 
might  in  part  expend  ft. 

The  accumulation  of  fenforial  power  from  the  defect  of  ac* 
Cuftomed  actions  feems  to  give  rife  to  fome  inordinate  mufcular 
motions,  as  the  inceflant  jumping  of  a  fquirrel  confined  in  a  cage, 
And  fome  of  the  motions  of  children  confined  too  long  in  fchools> 
which  are  called  tricks.     See  Clafs  III.  i.  i.  I.  and  IV.  i.  3.  2. 
And  I  am  inclined  to  think,  that  thefe  infanities,  which  are  term- 
ed melancholy,  where  no  previous  misfortune  has  occurred,  as  in* 
grief  or  difappointed  love,  but  where  the  patient  fits  perpetually 
brooding  over  fome  pain/ul  idea,  which  was  not  previoufly  ex- 
cited by  any  external  event,  as  in  the  tsedium  vitx,  are  in  g<  ' 
al  occafioned  by  accumulations  of  fenforial  power  5  and  the 
Jem  infanities  to  increafe  of   motive;   that  is,   to  thofe  pi  ins -or 
u-ant  of  pleafure,  which  excite  averllon  or  dcfirc. 


o 


304  DISEASES  CLASS  III.  r.  2, 

There  is  finally  reafon  to  believe,  that  not  only  fenforial  power 
in  general  is  capable  of  accumulation  in  thofe  parts  which 
have  been  accuftomed  to  almoft  perpetual  action  ;  but  alfo  that 
each  kind  or  fpecies  of  fenforial  power,  as  that  of  irritation, 
fenfation,  volition,  and  alTociation,  is  feparately  capable  of  accu- 
mulation in  the  parts,  which  have  almoft  perpetually  been  actu- 
ated by  it  :  which  I  hope  fometime  to  confider  more  at  large,  as 
I  fufpecT:  it  may  fupply  a  key  to  many  of  the  phenomena  not 
only  of  infanities  and  convulfions,  but  to  thofe  of  fever. 

The  difpofition  to  infanity,  as  well  as  to  convulfion,  is  believ- 
ed to  be  hereditary  ;  and  in  confequence  to  be  induced  in  thofe 
families  from  /lighter  caufes  than  in  others.  Convulfions  have 
been  (hewn  to  have  besn  moft  frequently  induced  by  pains  ow- 
ing to  defecl:  of  ftimulus,  as  the  (huddering  from  cold,  and  not 
from  pains  from  excefs  of  ftimulus,  which  are  generally  fucceed- 
ed  by  inflammation.  But  mfanities  are  on  the  contrary  gener- 
ally induced  by  pains  from  excefs  of  ftimulus,  as  from  the  too 
violent  actions  of  our  ideas,  as  in  common  anger,  which  is  an 
infanity  of  (hort  duration  ;  for  infanities  generally,  though  not 
always,  arife  from  pains  of  the  organs  of  fenfe  ;  but  convulfions 
generally,  though  not  always,  from  pains  of  the  membranes  or 
glands.  And  it  has  been  previoufly  explained,  that  though  the 
membranes  and  glands,  as  the  ftomach  and  Ikin,  receive  great 
pain  from  want  of  ftimulus  ;  yet  that  the  organs.  of  fenfe,  as  the 
eye  and  ear,  receive  no  pain  from  defeft  of  ftimulus. 

Hence  it  follows,  that  the  conftitutions  moft  liable  to  convul- 
fion,  are  thofe  which  moft  readily  become  torpid  in  fome  part 
of  the  fyftem,  that  is  which  poiTefs  lefs  irritability  ;  and  that 
thofe  moft  liable  to  infanity,  are  fuch  as  have  excefs  of  fenfibil- 
ity  ;  and  laftly,  that  thefe  two  circumftances  generally  exift  in 
the  fame  conftitutioii  ;  as  explained  in  Seel.  XXXI.  2.  on  Tern* 
perajnents.  Thefe  obfervations  explain  why  epilepfy  and  infan- 
ity frequently  fucceed  or  reciprocate  with  each  other,  and  why 
inirritable  habits,  as  fcrofulous  ones,  are  liable  to  infanity,  of 
which  I  have  known  fome  inftances. 

In  many  cafes  however  there  i$  no  appearance  of  the  difpofi- 
tion to  epilepfy  or  infanity  of  the  parent  being  tranfmitted  to 
progeny.  Firft,  where  the  infanity  has  arifenfrom  fome  vi- 
lent difappointment,  and  not  from  intemperance  in  the  ufe  of 
fpirituous  liquors.  Secondly,  where  the  parent  has  acquired  the 
infanity  or  epilepfy  by  habits  of  intoxifcation  after  the  procrea- 
tion of  his  children.  Which  habits  I  fuppofe  to  be  the  general 
e  of  the  difpofition  to  infanity  in  this  country.  See  Clafs 
til.  i.  i.  7. 

As  the  difpofition  to  gout,  dropfy,  epilepfy,  and  infanity,  ap- 

pears 


CLASS  III.  i.  2.  r.       OF  VOLITION;  305 

pears  to  be  produced  by  the  intemperate  ufe  of  fpirituous  po« 
tation,  and  is  in  all  of  them  hereditary  ;  it  feems  probable,  that 
this  difpofition  gradually  increafes  from  generation  to  generation, 
in  thofe  families  which  continue  for  many  generations  to  be  in- 
temperate in  this  refpecl  •,  till  at  length  thefe  difeafes  are  produc- 
ed ;  that  is,  the  irritability  of  the  fyftem  gradually  is  decreafed 
by  this  powerful  ftimulus,  and  the  fenfibilitv  at  :he  fame  time 
increafed,  as  explained  in  Seel.  XXXI.  I.  and  2.  This  difpofi* 
tion  is  communicated  to  the  progeny,  and  becomes  ftill  increaf- 
ed, if  the  fame  ftimulus  be  continued,  and  fo  on  by  a  third  and 
fourth  generation  ;  which  accounts  for  the  appearance  of  epilep- 
fy  in  the  children  of  fome  families,  where  it  was  never  known 
before  to  have  exifted,  and  could  not  be  afcribed  to  their  own 
intemperance.  A  parity  of  reafoning  {hews,  that  a  few  fober 
generations  may  gradually  in  the  fame  manner  reftore  a  due  de- 
gree of  irritability  to  the  family,  and  decreafe  the  excefs  of  fenfi- 
bility. 

From  hence  it  would  appear  probable,  that  fcrofula  and  drop- 
fy  are  difeafes  from  inirritability  ;  but  that  in  epilepfy  and  infan- 
ity  an  excefs  of  fenfibility  is  added,  and  the  two  faulty  temper- 
aments  are  thus  conjoined. 

SPECIES. 

I.  Mania  mutabilis.  Mutable  madnefs.  Where  the  patients 
are  liable  to  miftake  ideas  of  lenfation  for  thofe  from  irritation, 
that  is,  imaginations  for  realities,  if  cured  of  one  fource  of  infan- 
ity,  they  are  liable  in  a  few  months  to  find  another  fource  in 
fome  new  miftaken  or  imaginary  idea,  and  to  acl:  from  this  new 
idea.  The  idea  belongs  to  delirium,  when  it  is  an  imaginary  or 
miftaken  one  ;  but  it  is  the  voluntary  actions  exerted  in  confe- 
quence  of  this  miftaken  idea,  which  conftitute  infanity. 

In  this  difeafe  the  patient  is  liable  carefully  co  conceal  the 
object  of  his  defire  or  averfion.  But  a  ..vnftant  inordinate  fuf- 
picion  of  all  people,  and  a  careleflhefs  of  cleanlinefs,  and  of  de- 
cency, are  generally  concomitants  of  madnefs.  Their  defigns 
cannot  be  counteracted,  till  you  can  inveftigate  the  delirious 
idea  or  object  of  their  infanity  ;  but  as  they  are  generally  timid,' 
they  are  therefore  lefs  to  be  dreaded. 

Z.  Z.  called  a  young  girl,  one  of  his  maid-fervants,  into  the 
parlour,  and,  with  cocked  piftols  in  his  hands,  ordered  her  to 
ftrip  herfelf  naked  ;  he  then  infpected  her  with  fome  attention, 
and  difmified  her  untouched.  Then  he  ftripped  two  of  his 
male  fervants  in  the  fame  manner,  to  the  great  terror  of  the 
neighbourhood-  After  he  was  fecured,  with  nyich  difficulty  he 

VOL.  II.  CL  was 


DISEASES  CLASS  III.  1.2.1, 

was  perfuaded  to  tell  me,  that  he  had  got  the  itch,  and  had  ex- 
amined fome  of  his  fervants  to  find  out  from  whom  he  had  re- 
ceived it  ;  though  at  the  fame  time  there  was  not  a  fpot  to  be 
feen  on  his  hands,  or  other  parts.  The  outrages  in  confequence 
of  this  falfe  idea  were  in  fome  meafure  to  be  afcribed  to  the 
pride  occafioned  by  unreftrained  education,  affluent  wealth,  and. 
dignified  family. 

Madnefs  is  fometimes  produced  by  bodily  pain,  particularly 
I  believe  of  a  difeafed  liver,  like  convulfion  and  epilepfy ;  at 
other  times  it  is  caufed  by  very  painful  ideas  occafioned  by  ex- 
ternal circumltances,  as  of  grief,  or  difappointment  j  but  the 
nioft  frequent  caufe  of  infanity  arifes  from  the  pain  of  fome 
imaginary  or  miftaken  idea  ;  which  may  be  termed  hallucinatio 
rnaniacalis.  This  hallucination  of  one  of  the  fenfes  is  often 
produced  in  an  inftant,  and  generally  becomes  gradually  weak- 
ened in  procefs  of  time,  by  the  perpetual  ftimulus  of  external 
objects,  or  by  the  fucceflions  or  other  catenations  of  ideas,  or  by 
the  operations  of  medicines  ;  and  when  the  maniacal  hallucina- 
tion ceafes,  or  is  forgotten,  the  violent  exertions  ceafe,  which 
were  in  confequence  of  it,  and  the  difeafe  is  cured. 

Mr. ,  a  clergyman,  about  forty  years  of  age,  who  was 

rather  a  weak  man,  happened  to  be  drinking  wine  in  jocular 
company,  and  by  accident  fwallowed  part  of  the  feal  of  a  letter, 
which  he  had  juft  then  received  ;  one  of  his  companions  feeing 
him  alarmed,  cried  out  in  humour,  "  It  will  feal  your  bowels  up." 
He  became  melancholy  from  that  inftant,  and  in  a  day  or  two 
refufed  to  fwallow  any  kind  of  nourishment.  On  being  preiTed  to 
give  a  reafon  for  this  refufal,  he  anfwered  he  knew  nothing  would 
pafs  through  him.  A  cathartic  was  given,  which  produced  a 
great  many  evacuations,  but  he  flill  perfifted,  that  nothing  pant- 
ed through  him  ;  and  though  he  was  frightened  into  taking  a 
little  broth  once  or  twice  by  threats,  yet  he  foon  ceafed  intirely 
to  fwallow  any  thing,  and  died  in  confequence  of  this  infane  idea. 

Mils ,  a  fenfible  and  ingenious  lady,  about  thirty,  faid 

fhe  had  feen  an  angel  ;  who  told  her,  that  (he  need  not  eat, 
though  all  others  were  under  the  neceffity  of  fupporting  their 
earthly  exiftence  by  food.  After  fruitlefs  perfuafions  to  take 
food,  fhe  ftarved  herfelf  to  death.-— It  was  propofed  to  fend  an 
angel  of  a  higher  order  to  tell  her,  that  now  ihe  muff  begin  to 
eat  and  drink  again  ;  but  it  was  not  put  into  execution. 

Mrs.  ,/  a  lady  between  forty  and  fifty  years  of  age, 

imagined  that  fhe  heard  a  voice  fay  to  her  one  day,  as  fhe  was 
at  her  toilet,  "  Repent,  or  you  will  be  damned."  From  that 
moment  fhe  became  melancholy,  and  this  hallucination  affe&ed 

her 


CLASS  III.  i.  2.  i.        OF  VOLITION.  307 

her  in  greater  or  lefs  degree  for  about  two  years  ;  fhe  then  re- 
covered perfectly,  and  is  now  a  cheerful  old  woman. 

Mrs.  -,  a  farmer's  wife,  going  up  ftairs  to  drefs,  found 

the  curtains  of  her  bed  drawn,  and  on  undrawing  them,  {he  be- 
lieved that  fhe  faw  the  corpfe  of  her  fifter,  who  was  then  ill  at 
the  diflance  of  twenty  miles,  and  became  from  that  time  infane  ; 
and  as  her  fifter  died  about  that  time,  fhe  could  not  be  produc- 
ed to  counteract  the  infane  hallucination,  but  fhe  perfectly  re- 
covered in  a  few  months. 

Mrs. ,  a  moil  elegant,  beautiful,  and  aceomplifned  la- 
dy, about  twenty-two  years  of  age.,  had  been  married  about  two 
months  to  an  elegant,  polifhed,  and  affluent  young  man,  and  it 
was  well  known  to  be  a  love-match  on  both  fides.  She  fudden- 
ly  became  melancholy,  and  yet  not  to  fo  great  a  degree,  but 
that  fhe  could  command  herlelf  to  do  the  honours  of  her  table 
with  grace  and  apparent  eafe.  After  many  days  intreaty,  fhe 
at  length  told  me,  that  fhe  thought  her  marrying  her  hufband 
had  made  him  unhappy  ;  and  that  this  idea  fhe  could  not  efface 
from  her  mind  day  or  night.  I  withflood  her  being  confined, 
as  fome  had  advifed,  and  propofed  a  fea-voyage  to  her,  with  ex- 
pectation that  the  ficknefs  as  well  as,change  of  objects,  might 
remove  the  infane  hallucination,  by  introducing  other  energetic 
ideas  ;  this  was  not  complied  with,  but  fhe  travelled  about  Eng-» 
land  with  her  friends  and  her  hufband  for  many  months,  and 
at  length  perfectly  recovered,  and  is  now  I  am  informed  in  health 
and  fpirits. 

Thefe  cafes  are  related  to  fliew  the  utility  of  endeavouring  to 
inveftigate  the  maniacal  idea,  or  hallucination  ;  as  it  may  not 
only  acquaint  us  with  the  probable  defigns  of  the  patient,  from 
whence  may  be  deduced  the  neceffity  of  confinement ;  but  alfo 
may  fome  time  lead  to  the  moil  effectual  plan  of  cure. 

I  received  good  information  of  the  truth  of  the  following  cafe, 
which  was  publifhed  a  few  years  ago  in  the  newfpapers.  A 
young  farmer  in  Warwickfhire,  finding  his  hedges  broke,  and 
the  flicks  carried  away  during  a  froily  feafon,  determined  to 
watch  for  the  thief.  He  lay  many  cold  hours  under  a  hay- 
flack,  and  at  length  an  old  woman,  like  a  witch  in  a  play,  ap- 
proached, and  began  to  pull  up  the  hedge  ;  he  waited  till  fhe  had 
tied  up  her  bottle  of  flicks,  and  was  carrying  them  off,  that  he 
might  convicl  her  of  the  theft,  and  then  Ipringing  from  his  con- 
cealment, he  feized  his  prey  with  violent  threats.  After  fome 
altercation,  in  which  her  load  was  left  upon  the  ground,  fhe 
kneeled  upon  her  bottle  of  flicks,  and  raifing  her  arms  to  Heaven 
beneath  the  bright  moon  then  at  the  full,  fpoke  to  the  farmer  al- 
ready fhivering  with  cold,  «  Heaven  grant,  that  thou  never  mnyefl 

know 


3oS  DISEASES  CLASS  III.  i.  2.  i. 

know  again  the  bleffing  to  be  warm.**  He  complained  of  cold 
all  the  next  day,  and  wore  an  upper  coat,  and  in  a  few  days 
another,  and  in  a  fortnight  took  to  his  bed,  always  faying  nothing 
made  him  warm,  he  covered  himfelf  with  very  many  blankets, 
and  had  a  fieve  ever  his  face,  as  he  lay ;  and  from  this  one  in- 
fane  idea  he  kept  his  bed  above  twenty  years  for  fear  of  the  cold 
air,  till  at  lengih  he  c; 

M.  M.  As  mania  arifes  from  pain  either  of  our  jrmfcles  or 
organs  of  fenfe,  the  arts  of  relieving  pain  muft  conftitute  the 
method  of  cure.  See  Sea.  XXXIV.  3.  4.  Venefedion. 
Vomits  of  from  five  grains  to  ten  of  emetic  tartar,  repeated  ev- 
ery third  morning  for  three  or  four  times  j  with  folution  of 
gum  ammoniac,  and  folubie  tartar,  fo  as  to  purge  gently  every 
day.  Afterwards  warm  br.ch  for  two  or  three  hours  a  day. 
Opium  in  iarj.;e  dofes.  Bark.  Steel. 

Dr.  Binns  gave  two  fcruples  (40  grains)  of  folid  opium  at  a 
dofe,  and  twenty  grains  four  hours  afterwards  ;  which  reftored 
the  patient.  Dr.  Brandreth  gave  400  drops  of  laudanum  to  a 
maniac  in  the  greateft  poflible  furor,  and  in  a  few  hours  he  be~ 
came  calm  and  rational.  Med.  Comment,  for  1791,  p.  384. 

Prognoftic. 

THE  temporary  quick  pulfe  attending  fome  maniacal  cafes  is 
(imply  a  fymptom  of  debility,  and  is  the  confequence  of  too 
great  exertions  ;  but  a  permanent  quick  pulfe  {hews  the  pref- 
$nce  of  fever,  and  is  frequently  a  falutary  fign  ;  becaufe,  if  the 
life  of  the  patient  be  fafe,  when  the  fever  ceafes,  the  infanity 
generally  vanifhes  along  with  it,  as  mentioned  above.  In  this 
cafe  the  kind  of  fever  muft  direct  the  method  of  curing  the  in- 
fanity ;  which  muft  confift  of  moderate  evacuations  and  diluents, 
if  the  pulfe  be  ftrong  ;  or  of  nutrientia,  bark,  and  fmall  dofes 
of  opium,  if  the  pnlfe  be  weak. 

Where  the  caufe  is  of  a  temporary  nature,  as  in  puerperal 
infanity,  there  is  reafon  to  hope,  that  the  dileafe  will  ceafe, 
when  the  bruifes,  or  other  painful  fenfations  attending  this  ilate, 
are  removed.  In  thefe  cafes  the  child  (hould  be  brought  fre- 
quently to  the  mother,  and  applied  to  her  breaft,  if  fhe  will  fuf- 
fer  it,  and  this  whether  me  at  firft  attends  to  it  or  not ;  as  by  a 
few  trials  it  frequently  excites  the  ftorge,  or  maternal  affection, 
and  removes  the  infanity,  as  I  have  witneffed. 

When  the  madnefs  is  occafioncd  by  pain  of  the  teeth,  which 
I  believe  is  no  uncommon  cafe,  theie  muft  be  extracted  ;  and 
the  cure  follows  the  extinction  of  the  pain.  There  is  however 
iome  difficulty  in  detecting  the  delinquent  tooth  in  this  cafe3  as 

in 


CLASS  III.  i.  2.2.          OF  VOLITION.  30? 

in  hemicrania,  imlefs  by  its  apparent  decay,  or  by  fome  previ- 
ous information  of  its  pain  having  been  complained  of ;  be- 
caufe  the  pain  of  the  tooth  ceafes,  asfoon  as  the  exertions  of  in- 
fanity commence.  In  this  cafe  falivation  might  be  tried. 

When  a  perfon  becomes  in  fane,  who  has  a  family  of  fmall 
children  to  folicit  his  attention,  the  prognoftic  is  very  unfavour- 
able ;  as  it  (hews  the  maniacal  hallucination  to  be  more  pow- 
erful than  thofe  ideas  which  generally  intereft  us  the  moft. 

When  an  infane  young  man  {hews  no  lafcivious  idea,  when 
an  opportunity  of  gratifying  the  paflion  of  love  is  preiented  to 
him,  as  in  the  cafe  above  mentioned  of  Z.  Z.  or  when  an  in- 
fane young  lady  (hews  no  fymptom  of  attachment,  when  ad- 
dreffed  honourably  by  a  proper  lover,  the  prognoftic  is  unfa- 
vourable, as  it  (hews  the  maniacal  hallucination  to  affect  the 
mind  flronger  than  the  natural  paffton  of  love,  which  in  civilized 
fociety  is  ftrengthened  by  reftraint. 

Paralytic  affections  are  faid  by  Mr.  Haflam,  to  be  frequently 
fucceeded  by  infanity,  and  that  in  thefe  cafes  the  inactivity  of 
fome  paralytic  mufcles  about  the  face  or  limbs  with  "defective 
memory  continue  along  with  the  infanity  ;  and  he  adds  that  thefe 
patients  are  feldom  relieved.  Obfeiyations  on  Infanity  by  J. 
Haflam,  8vo.  Rivington.  It  was  before  obferved,  that  when 
fome  limbs  become  paralytic,  as  in  the  common  hemiplegia, 
that  the  other  limbs  are  liable  to  be  for  fome  time  in  almoft  per- 
petual action,  owing  to  the  fuperfluity  of  volition,  which  was 
previoufly  expended  by  the  action  of  thofe  mufcles,  which  are 
how  rendered  dilbbedient  to  the  fenforial  power  of  volition, 
though  they  may  continue  to  be  excitable  by  irritation  or  fenfa- 
tion,  as  in  the  act  of  pandiculation,  or  by  electric  (hocks.  Now 
if  this  fuperfluity  of  voluntary  activity  be  exerted  on  the  organs 
of  fenfe,  delirious  hallucinations  and  infane  actions  are  the  con- 
fequencc  ;  and  as  the  power  of  life  is  already  injured  in  a  part 
of  the  fyftem,  they  are  lefs  liable  to  recover,  and  die  like  other 
paralytic  patients.  And  thus  the  infanities  in  confequence  of 
paralytic  affections,  as  well  as  thofe  in  confequence  of  pain- 
ful fenfations  or  ideas,  countenance  the  theory,  that  they 
arife  from  the  exceflive  activity  of  the  fenforial  power  of  voli- 
tion. 

2.  Stitdium  inane.  Reverie  confifts  of  violent  voluntary  c 
tions  of  ideas  to  relieve  pain,  with  all  the  trains  or  tribes  con- 
nected  with  them  by.  fenfations  or  affociations.  It  frequently 
alternates  with  epileptic  convulfions  ;  with  which  it  corresponds, 
in  refpect  to  the  infenfibility  of  the  mind  to  the  ftimuli  of  ex- 
ternal objects,  in  the  fame  manner  as  madnefs  correfponds  with 

common 


DISEASES  CLASS  III.  i.  2.  2. 

common  convulfion,  in  the  patient's  pofTefllng  at  the  fame  time  a 
fenfibility  of  the  ftimuli  of  external  objects. 

Some  have  been  reported  to  have  been  involved  in  reverie  fo 
perfectly,  as  not  to  have  been  dilturbed  by  the  difcharge  of  a 
cannon  ;  and  others  to  have  been  infenfible  to  torture,  as  the 
martyrs  for  religious  opinions  ;  but  thefe  feem  more  properly 
to  belong  to  particular  infanities  than  to  reverie,  like  noftalgia 
and  erotomania. 

Reverie  is  diftinguifhed  from  madnefs  as  defcribed  above  ; 
and  from  delirium,  becaufe  the  trains  of  ideas  are  kept  confid- 
ent by  the  power  of  volition,  as  the  perfon  reafons  and  delib- 
erates in  it.  Somnambulifmus  is  a  part  of  reverie,  fomnambu- 
lifm  confifting  in  the  exertions  of  the  locomotive  mufcles,  and 
reverie  in  the  exertions  of  the  organs  of  fenfe  ,  See  Clafs  I.  I . 
j.  9.  and  Seel.  XIX.  both  which  are  mixed,  or  alternate  with 
each  other  for  the  purpofc  of  relieving  pain. 

When  the  patients  in  reverie  exert  their  volition  on  their  or. 
gans  of  fenfe,  they  can  occafionally  perceive  the  ftimuli  of  ex. 
ternal  objects,  as  explained  in  Seel.  XIX.  And  in  this  cafe  it 
refembles  fometimes  an  hallucination  of  the  fenfes,  as  there  is  a 
mixture  of  fael  and  imagiriation  in  their  difcourfe  ;  but  may  be 
thus  diftinguifhed  :  hallucinations  of  the  fenfes  are  allied  to  de- 
lirium, and  are  attended  generally  with  quick  pulfe,  and  other 
fyinptoms  of  great  debility;  but  reverie  is  without  fever,  and 
generally  alternates  with  convulfions  ;  and  fo  much  intuitive 
analogy  (fee  Seel:.  XVII.  3.  7.)is  retained  in  its  paroxyfms,  as  to 
preferve  a  confiftency  in  the  trains  of  ideas. 

Mifs  G ,  whofe  cafe  is  related  in  Seel.  III.  5.  8.  laid  as 

I  once  fat  by  her,  "  My  head  is  fallen  off,  fee  it  is  rolled  to  that 
corner  of  the  room,  and  the  little  black  dog  is  nibbling  the  nofe 
off."  On  my  walking  to  the  place  which  (he  looked  at,  and 
returning,  and  afluring  her  that  her  nofe  was  unhurt,  me  be- 
came pacified,  though  I  was  doubtful  whether  me  attended  to 
me.  See  Clafs  III.  i.  1.9.  and  Clafs  III.  I.  2.  2. 

M.  M.  Large  dofes  of  opium  given  before  the  expedled  par- 
oxyfm,  as  in  epilepfia  dolorifica,  Clafs  III.  i.  i.  8. 

The  hallucinatio  ftudiofa,  or  falfe  ideas  in  reverie,  differ 
from  maniacal  hallucinations  above  defcribed,  as  no  infane  ex- 
ertions fucceed,  and  in  the  patients  whom  I  have  feen  they 
have  always  been  totally  forgotten,  when  the  paroxyfm  was 
over. 

Mafter ,  a  fchool-boy  about  twelve  years  old,  after  he 

came  out  of  a  convulfion  fit  and  fat  up  in  bed,  faid  to  me, 
«  Dont  you  fee  my  father  Handing  at  the  feet  of  the  bed,  he  is 
come  a  long  way  on  foot  to  fee  me."  I  anfwered,  no  :  "  What 

colour 


CLASS  III.  1.1.3.        OF  VOLITION.  3 1 i 

colour  is  his  coat  ?"  He  replied,  «  A  drab  colour."  «  And 
what  buttons  ?"  "  Metal  ones,"  he  anfwered,  and  added,  "  how 
fadly  his  legs  are  fwelled."  In  a  few  minutes  he  faid,  with  ap- 
parent furprife,  "  He  is  gone/*  and  returned  to  his  perfect  mind. 
Other  cafes  are  related  in  Seft  XIX.  and  XXXIV.  3.  and  in 
Clafs  III.  i.  2.  2.  with  further  obfervations  on  this  kind  of 
hallucination  $  which  however  is  not  the  caufe  of  reverie,  but 
conftitutes  a  part  of  it,  the  caufe  being  generally  fome  uneafy 
fenfation  of  the  body. 

3.  Vigilia.     Watchfulnefs  confifts  in  the  unceafing  exertion 
of  volition  ;  which  is  generally  caufed  by  fome  degree  of  pain 
either  of  mind  or  of  body,  or  from  defect  of  the  ufual  quantity 
of  pleafurable  fenfation  ;  hence  if  thofe,  who  are  accuftomed  to 
wine  at  night,  take  tea  inftead,  they  cannot  fleep.     The  fame 
happens  from  want  of  folid  food  for  fupper,  to  thofe   who  are 
accuftomed  to  ufe  it  j  as  in  thefe  cafes  there  is*  pain  or  defeft  of 
pleafure  in  the  ftomach. 

Sometimes  the  anxiety  about  fleeping,  that  is  the  defire  to 
fleep,  prevents  fleep  ;  which  confifts  in  an  abolition  of  defire  or 
will.  This  may  fo  far  be  compared  to  the  impediment  of  fpeech 
defcribed  in  Seel.  XVII.  i.  10.  as  the  interference  of  the  will 
prevents  the  efFecl  defired. 

Another  fource  of  watchfulnefs  may  be  from  the  too  great 
fecretion  of  fenforial  power  in  the  brain,  as  in  phrenzy,  and  as 
fometimes  happens  from  the  exhibition  of  opium,  and  of  wine  ; 
if  the  exhauftion  of  fenforial  power  by  the  general  actions  of  the 
fyftem  occafioned  by  the  ftimulus  of  thefe  drugs  can  be  fuppo- 
fed  to  be  lefs  than  the  increafed  fecretion  of  it. 

M.  M.  i.  Solid  food  to  fupper.  Wine.  Opium.  Warm 
bath.  2.  The  patient  (hould  be  told  that  his  want  of  fleep  is  of 
no  confequence  to  his  health*  3.  Venefection  by  cupping.  Ab- 
flinence  from  wine.  4.  A  blifter  by  ftimulating  the  (kin,  and 
rhubarb  by  ftimulating  the  bowels,  will  fometimes  induce  fleep. 
Exercife.  An  uniform  found,  as  of  a  paufing  drop  of  water, 
or  the  murmur  of  bees.  Other  means  are  defcribed  in  Sect. 

XVIII.     20. 

4.  Erotomania.     Sentimental    love.     Defcribed  in  its  excefs 
by  romance  writers  and  poets.     As  the  object  of  love  is  beauty, 
and  as  our  perception  of  beauty  confifts  in  a  recognition  by  the 
fenfe  of  vifion  of  thofe  objects,  which  have  before  infpired  our 
love,  by  the  pleafure  they  have  afforded  to  many  of  our  fen  ft  s 
(Sect.  XVI.  6.) ;   and  as  brute  animals  have   lefs  accuracy  of 
their  fenfe  of  vifion  than  mankind  (ib.) ;  we  fee  the  reafon  why 
this  kind  of  love  is  not  frequently  obfervable  in  the  brute  crea- 
tion, except  perhaps  in  fome  married  birds,  or  in  the  affection  of* 

the 


$12  DISEASES  CLASS  III.  i.  2. 3. 

the  mother  to  her  offspring.  Men  who  have  not  had  leifure  to 
cultivate  their  tafte  for  vifible  objects,  and  who  have  not  read  the 
works  of  poets  and  romance-writers,  are  lefs  liable  to  fentimen- 
tal  love  ;  and  as  ladies  are  educated  rather  with  an  idea  of  being 
chofen,  than  of  choofing  ;  there  are  many  men  and  more  wom- 
en, who  have  not  much  of  this  infinity  ;  and  are  therefore  more 
eafily  induced  to  marry  for  convenience  or  mtereft,  or  from  the 
flattery  of  one  fex  to  the  other. 

In  its  fortunate  gratificatjon  fentimental  love  is  fuppofed  to 
fupply  the  pureft  fource  of  human  felicity  ;  and  from  the  fud- 
dennefs  with  which  many  of  thofe  patients,  defcribed  in  fpecies 
I.  of  this  genus,  were  feized  with  the  maniacal  hallucination, 
there  is  reafon  to  believe,  that  the  moft  violent  fentimental  love 
may  be  acquired  in  a  moment  of  time,  as  reprefented  by  Shakf- 
peare  in  the  beginning  of  his  Romeo  and  Juliet,  as  originally 
written. 

Some  have  endeavoured  to  make  a  diflinction  between  beau- 
ty and  grace,  and  have  made  them  as  it  were  rivals  for  the  pof- 
feflion  of  the  human  heart ;  but  grace  may  be  defined  beauty  in 
action  ;  for  a  fleeping  beauty  cannot  be  called  graceful  in  what- 
ever attitude  me  may  recline  ;  the  mufcles  mutt  be  in  action  to 
produce  a  graceful  attitude,  and  the  limbs  to  produce  a  grace- 
ful motion.  But  though  the  object  of  love  is  beauty,  yet  the 
idea  is  neverthelefs  much  enhanced  by  the  imagination  of  the 
lover  ;  which  nppears  from  this  curious  circumftance,  that  the 
lady  of  his  paffion  feldom  appears  fo  beautiful  to  the  lover  after 
a  few  months  feparation,  as  his  ideas  had  painted  her  in  his 
abfence  ;  and  there  is  on  that  account,  always  a  little  difappoint- 
ment  felt  for  a  minute  at  their  next  interview  from  this  halluci- 
nation of  his  ideas. 

This  pafllon  of  love  produces  reverie  in  its  firft  Mate,  which 
exertion  alleviates  the  pain  of  it,  and  by  the  affiftance  of  hope 
converts  it  into  pleafure.  Then  the  lover  feeks  folitude,  left 
this  agreeable  reverie  (hould  be  interrupted  by  external  flimuli, 
as  defcribed  by  Virgil. 

Tantum  inter  denfas,  umbrofa  cacumina,  fagos 
Aflidue  veniebat,  ibi  hxc  incondita  folus 
Montibus  et  fylvis  ftudio  ja&abat  inani. 

When  the  pain  of  love  is  fo  great,  as  not  to  be  relieved  by  the 
exertions  of  reverie,  as  above  defcribed  ;  as  when  it  is  mifplaced 
on  an  object,  of  which  the  lover  cannot  poflefs  himfelf ;  it  may 
ftill  be  counteracted  or  conquered  by  the  ftoic  philofophy,  which 
ftrips  all  things  of  their  ornaments,  and  inculcates  "  nil  admira- 
ri."  Of  which  leflbns  may  be  found  in  the  meditations  of  Mar- 
cus 


CLASS  III.  1.2.4-        OF  VOLITION.  3 1 3 

cus  Antoninus.  The  maniacal  idea  is  faid  in  fome  lovers  to 
have  been  weakened  by  the  aftion  of  other  very  energetic  ideas  ; 
f'uch  as  have  been  occafioned  by  the  death  of  his  favourite  child, 
or  by  the  burning  of  his  houfe,  or  by  his  being  fliip wrecked.  In 
thole  cafes  the  violence  of  the  new  idea  for  a  while  expends  fo 
much  fenforial  power  as  to  prevent  the  exertion  of  the  mania- 
cal one  ;  and  new  catenations  fucceed.  On  this  theory  the  lov* 
cr's  leap,  fo  celebrated  by  poets,  might  effecT:  a  cure,  if  the  pa- 
tien't  efcaped  with  life. 

The  third  ftage  of  this  difeaie  I  fuppofe  is  irremediable  ;  when 
a  lover  has  previoufly  been  much  encouraged,  and  at  length 
meets  with  neglect  or  difdain ;  the  maniacal  idea  is  fo  painful 
as  not  to  be  for  a  moment  relievable  by  the  exertions  of  reverie, 
but  is  inftantly  followed  by  furious  or  melancholy  infanity  ;  and 
fuicide,  or  revenge,  have  frequently  been  the  confequence.  As 
wa<  lately  exemplified  in  Mr.  Hackman,  who  Ihot  Mifs  Ray  in 
the  lobby  of  the  playhoufe.  So  the  poet  defcribes  the  paffion 
of  Dido, 


-Mommur  inultx  ? — 


At  moriamur,  ait, — lie,  lie,  juvat  ire  fub  umbras ! 

The  fiery  of  Medsea  feems  to  have  been  contrived  by  Ovid> 
who  was  a  good  judge  of  the  fubjecl:,  to  reprefent  the  favage 
madnefs  occafioned  by  ill-requited  love.  Thus  the  poet, 

Earth  has  no  rage  like  love  to  hatred  turn'd, 
Nor  Hell  a  fury  like  a  woman  fcorn'd. 

DRTDIN. 

I  I-nce  it  appears  that  though  fentimental  love  does  not  fo 
frequently  arife  fpontaneoufly  in  female  bofoms,  yet  that  it  is 
liable  to  become  as  violent,  when  it  has  been  excited  by  the 
courtfhip  of  the  other  fex,  and  though,  when  it  is  rejected,  after 
courtfhip  has  produced  it,  it  is  not  always  fucceeded  by  fuch  vi- 
olent effects  as  thofc  above  mentioned  ;  which  may  be  afcribed 
to  the  greater  modefty  and  referve  of  their  education  ;  yet  the 
difappointed  pailion  is  liable  to  prey  upon  their  minds  even  to 
the  hazard  of  their  lives,  of  which  I  have  witneiTed  two  inftan- 
ces,  in  both  which  the  effecls  approached  to  that  occafioned  by 
great  grief.  See  Mceror,  Clafs  III.  i.  2.  10. 

One  of  thefe  ladies,  about  30  years  of  age,  was  defertedby  an 
Irii~h  gentleman,  who  was  foon  to  have  married  her ;  ihe  was 
fetzed  fuddenly  with  a  flupor,  which  by  thole,  who  were  not 
acquainted  with  the  caufe,  was  miftaken  for  a  kind  of  apoplexy  ; 
(he  gradually  recovered  fo  as  to  apply  to  her  ufual  habits  of  life, 

VOL.  II.  R  R  and 


314  DISEASES  CLASS  III.  1.2.$. 

and  in  four  or  five  years  regained  her  cheerfulnefs,  and  married 
another  man.  The  other  was  affe£ted  with  long  ftupor,  lofs  of 
digeftion,  and  total  inability  of  mind  and  body,  which  contin- 
ued a  year  or  two,  and  from  which  fhe  alfo  gradually  re- 
covered. 

5.  Amorfui.     Vanity  confifts  of  an  agreeable  reverie,  and  is 
well  ridiculed  in  the  itory  of  NarcifTus,  who  fo  long  contemplat- 
ed his  own  beautiful  image  in  the  water,  that  he  died  from  neg- 
3e£t  of  taking  fuftenance.     I  once  faw  a  handfome  young  man, 
who  had  been  fo  much  flattered  by  his  parents,  that  his   vanity 
rofe  fo  near  to  infanity,  that  one  might  difcern  by  his  perpetual 
attention  to  himfelf,  and  the  difficulty  with  which  he  arranged 
his  conversation,  that  the  idea  of  himfelf  intruded  itfelf  at  every 
comma  or  paufe  of  his  difcourfe.     In  this 'degree  vanity  muft 
afford  great   pleafure  to  the  pofleflbr  ;  and  when  it  exifts  with- 
in moderate  bounds,  may  contribute  much  to  the  happinefs  of 
focial  life. 

My  friend  Mr.  once  complained  to  me,  that  he  was 

much  troubled  with  bafhfulnefs  in  company,  and  believed  that 
it  arofe  from  his  want  of  perfonal  vanity  ;  on  this  account  he  de- 
termined on  a  journey  to  Paris,  when  Paris  was  the  centre  of 
.politenefs  5  he  there  learnt  to  drefs,  to  dance,  and  to  move  his 
hands  gracefully  in  converfation  •,  and  returned  a  moft  confum- 
mate  coxcomb.  But  after  a  very  few  years  he  relapfed  into  ruf- 
ticity  of  drefs  and  manners. 

M.  M.  The  .cure  of  vanity  may  be  attempted  by  excefs  of 
flattery,  which  will  at  length  appear  ridiculous,  or  by  its  famil- 
iarity will  ceafe  to  be  defired.  I  remember  to  have  heard  a 
itory  of  a  nobleman  in  the  court  of  France,  when  France  had  a 
court,  who  was  fo  difagreeably  vain  in  converfation,  that  the 
king  was  pleafed  to  direct  his  cure,  which  was  t'hus  performed. 
Two  gentlemen  were  directed  always  to  attend  him,  one  was 
to  fland  behind  his  chair,  and  the  other  at  a  refpeclful  diftance 
before  him ;  whenever  his  lordfhip  began  to  fpeak,one  of  them  al- 
ways, pronounced  "Lord  G.dlimaafre  is  going  tofay  the  bed  thing 
in  the  world/''  And,  as  foon  as  hisLordfhip  had  done  fpeaking,the 
other  attendant  pronounced,  <f  Lord  Galiimaufre  has  fpoken  the 
belt  thing  in  the  world."  Till  in  a  few  weeks  this  noble  lord 
was  fo  difguited  with  praife  that  he  ceafed  to  be  vain ;  and  his 
majefty  difmifled  his  keepers. 

6.  Nofta/gta.    Maladie  de  Pais.     Calenture.     An  unconquer- 
able defire  of  returning  to  one's  native  country,  frequent  in  long 
voyages,  in  which  the  patients  become  fo  infane  as  to   throw 
themfelves  into  the  fea,  miftaking  it  for  green  fields  or  meadows. 
The  Swils  are  faid  to  be  particularly  liable  to  this  difeafe,  and 

when 


CLASS  III.  i.  2. 7.          OF  VOLITION.  315 

when  taken  into  foreign  fervice  frequently  to  defert  from  this 
caufe,  and  efpecially  atter  hearing  or  tinging  a  particular  tune, 
which  was  ufed  in  their  village  dances,  in  their  native  country, 
on  which  account  the  playing  or  finging  this  tune  was  forbid  by 
the  punifliment  of  death.  Zwingerus. 

Dear  is  that  fhed,  to  which  his  foul  conforms, 
And  dear  that  hill,  which  lifts  him  to  the  ilorms. 

GOLDSMITH. 

7'.  Spes  religiofa.  Superstitious  hope.  This  maniacal  Hallu- 
cination in  its  milder  ftate  produces,  like  fentimental  love,  an 
agreeable  reverie ;  but  when  joined  with  works  of  fupereroga- 
tion,  it  has  occafioned  many  enormities.  In  India  devotees  con- 
fign  themfclves  by  vows  to  moil  painful  and  unceafmg  tortures, 
-  fuch  as  holding  up  their  hands,  till  they  cannot  retract  them  5 
hanging  up  by  hooks  put  into  the  thick  (kin  over  their  moulders, 
fitting  upon  {harp  points,  and  other  felf  torments.  While  iu 
our  part  of  the  globe  failing  and  mortification,  as  flagellation, 
has  been  believed  to  pleafe  a  merciful  Deity  !  The  ferenity,  with 
which  many  have  faffered  cruel  martyrdoms,  is  to  be  afcribed  to 
this  powerful  reverie. 

Mr. ,  a  clergyman,  formerly  of  this  neighbourhood,  be- 
gan to  bruife  and  wound  himfelf  for  the  fake  of  religious  morti- 
fication, and  patied  much  time  in  prayer,  and  continued  whole 
nights  alone  in  the  church.  As  he  had  a  wife  and  family  of 
fmall  children,  I  believed  the  cafe  to  be  incurable  ;  as  otherwife 
.the  affection  and  employment  in  his  family  connections  would 
have  oppofed  the  beginning  of  this  infanity.  He  was  taken  to 
a  madhoufe  without  effect,  and  after  he  returned  home,  continu- 
ed to  beat  and  Bruife  himfelf,  and  by  this  kind  of  mortification, 
and  by  fometimes  long  fading,  he  at  length  became  emaciated 
"and  died.  I  once  told  him  in  converfation,  that  "  God  was  a 
merciful  being,  and  could  not  delight  in  cruelty,  but  that  I  fup- 
pofed  he  worfhipped  the  devil."  He  was  (truck  with  this 
idea,  and  promifed  me  not  to  beat  himfelf  for  three  days,  and 
I  believe  kept  his  word  for  one  day.  If  this  idea  had  been  fre- 
quently forced  on  his  mind,  it  might  probably  have  been  of 
fervice. 

When  thefe  works  of  fupererogation  have  been  of  a  public 
nature,  what  cruelties,  murders,  mafTacres,  has  not  this  infanity 
introduced  into  the  world  ! — A  commander,  who  had  been  very 
active  in  leading  and  encouraging  the  bloody  deeds  of  St.  Bar- 
tholomew's day  at  Paris,  on  confefhng  his  fins  to  a  worthy  ec- 
clefiaftic  on  his  death-bed,  was  afked,  "  Have  you  nothing  to 
fay  about  St  Bartholomew  ?"  "  On  that  day,"  he  replied,  «  God 

Almighty 


3 1 6  DISEASES  CLASS  III.  1.2.8. 

Almighty  was  obliged  to  me  !" — The  fear  of  Hell  is  another 
infanity,  which  will  be  fpoken  of  below. 

8.  Superbiaflemmath.     Pride  of  family  has  frequently  form- 
ed a  maniacal  hallucination,  which  in  its  mild  ftate  has  confifted 
in  agreeable  reverie,  .but  when  it  has  been  fo  painful  as  to  de- 
mand homage  from  others,  it  has  frequently  induced  infane  ex-* 
ertions.     This  infanity  feems  to  have  exifted  in  the  flourifhing 
ftate  of  Rome,  as  now  all  over  Germany,  and  is  attacked  by  Ju~ 
venal  with  great  feverity,  a  fmall  part  of  which  I  (hall  here 

as  a  method  of  cure.     Sat.  8. 

Say,  what  avails  the  pedigree,  that  brings 
Thy  boafted  line  from,  heroes  or  from  kings ; 
Though  many  a  mighty  lord,  in  parchment  roll'd, 
Name  after  name,  thy  coxcomb  hands  unfold  ; 
Though  wreathed  patriots  crowd  thy  marble  halls, 
Or  fleel-clad  warriors  frown  along  the  walls ; 
While  on  broad  canvas  in  the  gilded  frame 
All  virtues  flourifh,  and  all  glories  flame  ?— 
Say, — if  ere  noon  with  idiot  laugh  you  lie 
Wallowing  in  wine,  or  cog  the  dubious  die, 
Or  aft  unfliamed,  by  each  indignant  buft, 
The  midnight  orgies  of  promiscuous  luft  !    ••  • 

Go,  lead  mankind  to  Virtue's  holy  Ihrinc, 
With  morals  mend  them,  and  with  arts  refine, 
Or  lift,  with  golden  characters  unfurl' d, 
The  flag  of  peace,  and  fave  a  warring  world !— 
— So  fhall  with  pious  hands  immortal  Fame 
Wreathe  all  her  laurels  round  thy  honour'd  name, 
High  o'er  thy  tomb  with  chiflel  bold  engrave, 

"  THE  TRULY  NOBLE  ARE  THE  GOOD  AND  BRAVE." 

9.  Ambitio.    Inordinate  defire  of  fame.     A  carelefihefs  about 
the  opinions  of  others  is  faid  by  Xenophon  to  be  the  fource  of 
impudence  ;  certainly  a  proper  regard  for  what  others  think  of 
us  frequently  incites  us  to  virtuous  actions,  and  deters  us  from 
vicious  ones  ;    and  increafes  our  happinefs  by  enlarging  our 
fphere  of  fympathy,  and  by  flattering  our  vanity. 

AbflraiSl  what  others  feel,  what  other*  think, 
All  pleafures  iicken,  and  all  glories  fink. 

POPE. 

When  this  reverie  of  ambition  excites  to  conquer  nations,  or 
to  enflave  them,  it  has  been  the  fource  of  innumerable  wars,  and 
the  occafion  of  a  great  devaftation  of  mankind.  Csefar  is  re- 
ported to  have  boafted,  that  he  had  deftroyed  three  millions  of 
his  enemies,  and  one  million  of  his  friends. 

The  works  of  Homer  are  fuppofed  to  have  done  great  injury  to 
mankind  by  hifpiring  the  love  of  military  glory.     Alexander  was 
to  fleep  with  them  always  on  his  pillow.     How  like  a  mad 

butcher 


I 


CLASS  lit.  i.  2.  10.      OF  VOLITION.  317 

butcher  amid  a  flock  of  flieep  appears  the  hero  of  the  Iliad,  in 
the  following  fine  lines  of  Mr.  Pope,  which  conclude  the  twen- 
tieth book. 

His  fiery  courfers,  as  the  chariot  rolls, 
Tread  down  whole  ranks,  and  crufh  out  heroes'  fouls  ; 
Bafli'd  from  their  hoofs,  as  o'er  the  dead  they  fly, 
Black  bloody  drops  the  fmoking  chariot  dye ; — 
The  fpiky  wheels  through  heaps  of  carnage  tore, 
And  thick  the  groaning  axles  dropp'd  with  gore ; 
High  o'er  the  fcene  of  death  ACHILLES  ftood, 
All  grim  with  duft,  all  horrible  with  blood ; 
Yet  ftill  infatiate,  ilill  with  rage  on  flame, 
Such  is  the  luft  of  never  dying  fame ! 

The  cure  muft  be  taken  from  moral  writers.  Woolafton 
fays,  Csefar  conquered  Pompey  ;  that  is,  a  man  whofe  name 
confided  of  the  letters  C,  se,  f,  a,  r,  conquered  a  long  time  ago 
a  man,  whofe  name  confided  of  the  letters  P,  o,  m,  p,  e,  y,  and 
that  this  is  all  that  remains  of  either  of  them.  Juvenal  alfo  at- 
tacks this  mode  of  infariity,  Sat.  X.  166. 

I,  demens,  et  faevas  curre  per  Alpes, 
Ut  pueris  placeas,  et  declamatio  fias  ! 

Which  is  thus  tranflated  by  Dr.  Johnfon, 

And  left  a  name,  at  which  the  world  grew  pale, 
To  point  a  moral,  or  adorn  a  tale ! 

10.  Mceror.  Grief.  A  perpetual  voluntary  contemplation 
of  all  the  circumftances  of  fome  great  lofs,  as  of  a  favourite 
child.  In  general  the  painful  ideas  gradually  decreafe  in  ener- 
gy, and  at  length  the  recollection  becomes  more  tender  and  lefs 
painful.  The  letter  of  Sulpicius  to  Cicero  on  the  lofs  of  his 
daughter  is  ingenious.  The  example  of  David  on  the  lofs  of  his 
child  is  heroic. 

A  widow  lady  was  left  in  narrow  circumftances  with  a  boy 
and  a  girl,  two  beautiful  and  lively  children,  the  one  fix,  and 
the  other  feven  years  of  age ;  as  her  circumftances  allowed  her 
to  keep  but  one  maid-fervant,  thefe  two  children  were  the  fole 
attention,  employment,  and  confolation  of  her  life  ;  (lie  fed 
them,  drefled  them,  flept  with  them,  and  taught  them  herfelf  ; 
they  were  both  fnatched  from  her  by  the  gangrenous  fore  throat 
in  one  week  :  fo  that  (he  loft  at  once  all  that  employed  her,  as 
well  as  all  that  was  dear  to  her.  For  the  firft  three  or  four 
days  after  their  death,  when  any  friend  vifited  her,  (he  fat  up- 
right, with  her  eyes  wide  open,  without  medding  tears,  and  af- 
fected to  fpeak  of  indifferent  things.  Afterwards  me  begnn  to 
weep  much,  *nd  for  fome  weeks  talked  to  her  friends  of  noth- 
ing 


3i*  "  DISEASES  CLASS  III.  i.  2.  n. 

ing  elfe  but  her  dear  children.  But  di.^1  not  for  many  years, 
even  to  her  dying  hour,  get  quite  over  a  gloom,  which  was  left 
upon  her  countenance. 

In  violent  grief,  when  tears  flow,  it  is  efteemed  a  good  fymp- 
tom  ;  becaufe  then  the  actions  caufed  by  fenfitive  aflbciation  take 
the  place  of  thofe  caufed  by  volition  ;  that  is,  they  prevent  the 
voluntary  exertions  of  ideas,  or  mufcular  actions,  which  confti- 
tute  infanity. 

The  fobbing  and  fighing  attendant  upon  grief  are  not  convul- 
five  movements,  they  are  occafioned  by  the  fenforial  power  be- 
ing fo  expended  on  the  painful  ideas,  and  their  connections, 
that  the  perfon  neglects  to  breathe  for  a  time,  and  then  a  vio- 
lent figh  or  fob  is  neceflary  to  carry  on  the  blood,  which  opprefles 
the  pulmonary  veflels,  which  is  then  performed  by  deep  or  quick 
infpirations,  and  laborious  expirations.  Sometimes  neverthelefs 
the  breath  is  probably  for  a  while  voluntarily  held,  as  an  effort  to 
relieve  pain.  The  palenefs  and  ill  health  occafioned  by  long 
grief  are  fpoken  of  in  Clafs  IV.  2.  1.9. 

The  melioration  of  grief  by  time,  and  its  being  at  length  even 
attended  with  pleafure,  depends  on  our  retaining  a  diftinct  idea 
of  the  loft  object:,  and  forgetting  for  a  time  the  idea  of  the  lofs 
of  it.  This  pleafure  of  grief  is  beautifully  defcribed  by  Aken- 
fide.  Pleafures  of  Imagination,  Book  II.  1.  680. 


-Afk  the  faithful  youth, 


Why  the  cold  urn  of  her,  whom  long  he  loved, 

So  often  fills  his  arms ;  fo  often  draws 

His  lonely  fooriieps  at  the  lilent  hour 

To  pay  the  mournful  tribute  of  his  tears  ? 

Oh  !  he  will  tell  thee,  that  the  wealth  of  worlds 

Should  ne'er  fcduce  his  bofom  to  forego 

That  facred  hour  ;  when,  Healing  from  the  noife 

Of  care  and  envy,  fweet  remembrance  foothes 

With  Virtue's  kindeft  looks  his  aching  breaft, 

And  turns  his  tears  to  rapture. 

M.  M.  Confolation  is  beft  fupplied  by  tfye  Chriftian  doctrine 
of  a  happy  immortality.  In  the  Pagan  religion  the  power  of 
dying  was  the  great  confolation  in  irremediable  diftrefs.  Seneca 
fays,  u  no  one  need  be  unhappy  unlefs  by  his  own  fault."  Arid 
the  author  of  Telemachus  begins  his  work  by  faying,  that  Ca- 
lypfo  could  not  confole  herfelf  for  the  lofs  of •Ulyfles,  and  found 
herfelf  unhappy  in  being  immortal.  In  the  firft  hours  of  grief 
the  method  of  confolation  ufed  by  uncle  Toby,  in  Triftram 
Shandy,  is  probably  the  beft  ;  "  he  fat  down  in  an  arm  chair  by 
the  bed  of  his  diitrelied  friend,  and  faid  nothing." 

11.  tadsitm  vita.  Ennui.  Irkfomenefs  of  life.  The  inani- 
ty of  fublunary  things  has  afforded  a  theme  to  philofophers, 

nioralifts, 


I 


CLASS  III.  i.  2.  1 1.      OF  VOLITION.  319 

moralifts,  and  divines,  from  the  earlieft  records  of  antiquity  ; 
"  Vanity  of  vanities  ["  fays  the  preacher,  «  all  is  vanity  !"  Sol- 
omon. "  Man  is  the  dream  of  a  (hadow  !"  Sx<»j  ma.?  xvfyaw,, 
Pindar.  O  !  quantum  eft  in  rebus  inane  !  Juvenal.  Nor  is 
there  any  one,  I  fuppofe,  who  has  palled  the  meridian  of  life, 
who  has  not  at  fome  moments  felt  the  nihility  of  all  things. 

Wearinefs  of  life  or  ennui  in  its  moderate  degree  has  been  ef- 
teemed  a  motive  to  action  by  fome  philofophers.  See  Sect. 
XXXIV.  2.  3.  But  in  thofe  men,  who  have  run  through  the 
ufual  amufements  of  life  early  in  refpect  of  their  age  j  and  who 
have  not  induftry  or  ability  to  cultivate  thofe  fciences,  which  af- 
ford a  perpetual  fund  of  novelty,  and  of  confequent  entertain- 
ment, are  liable  to  become  tired  of  life,  as  they  fuppofe  there  is 
nothing  new  to  be  found  in  it,  that  can  afford  them  pleafure  ; 
like  Alexander,  who  is  faid  to  have  fhed  tears  becaufe  he  had  not 
another  world  to  conquer. 

Mr. ,  a  gentleman,  about  fifty,  of  poliflied  manners, 

who  in  a  few  months  afterwards  deftroyed  himfelf,  faid  to  me 
one  day,  "  A  ride  out  in  the  morning,  and  a  warm  parlour  and 
a  pack  of  cards  in  the  afternoon,  are  all  that  life  affords."  He 
was  perfuaded  to  have  an  iflue  on  the  top  of -his  head,  as  he  com- 
plained of  a  dull  head-ach,  which  being  unfkilfully  managed, 
deftroyed  the  pericranium  to  the  fize  of  an  inch  in  diameter  ; 
during  the  time  this  took  in  healing,  he  was  indignant  about  it, 
and  endured  life,  but  foon  afterwards  (hot  himfelf. 

Mr. ,  a  gentleman  of  Gray's  Inn,  fome  years  ago  was  pre- 
vailed upon  by  his  friends  to  difmifs  a  miftrefs,  by  whom  he  had 
a  child,  but  who  was  fo  great  ji  termagant  and  fcold,  that  (he 
was  believed  tq.ufe  him  very  iil,:3^even  to  beat  him.  He  be- 
came melancholy  in  two  days  from  the  want^|phis  ufual  ftimu- 
lus  to  action,  and  cut  his  throat  on  the  third  fo  completely,  that 
lie  died  immediately. 

Mr.  A  nfon,  the  brother  to  the  late  lord  Anfon,  related  to  me 

the  following  anecdote  of  the  death  of  lord  Sc .    His  lord- 

fliip  fent  to  fee  Mr.  Anfon  on  the  Monday  preceeding  his 
death,  and  faid,  "  You  are  the  only  friend  I  value  in  the  world, 
I  determinlHjherefore  to  acquaint  you,  that  I  am  tired  of  tl^| 
infipidity  ofWPe,  and  intend  to  morrow  to  leave  it."  Mr.  A 
faid,  after  much  converfation,  that  he  was  obliged  to  leave  town 
till  Friday,  and- .added,  "As  you  profefs  a  friend  (hip  for  me,  do 
me  this  laft  favour,  1  entreat  you,  live  till  I  return."  Lord 

Sc believed  this  to  be  a  pious  artifice  to  gain  time,  but  ncv- 

erthclefs  agreed,  if  he  mould  return  by  four  o'clock  on  I 
Mr.   Anfon  did  not  return  till  five,  and  perceived  by  the  coun- 
tenances of  the  domcftics,  that  tfie  deed  was   done.     He  :- 


32°  DISEASES  CLASS  III.  1.2.  u. 

into  his  chamber  and  found  the  corpfeof  his  friend  leaning  over 
the  arm  of  a  great  chair,  with  the  piflol  on  the  ground  by  him, 
the  ball  of  which  had  been  difcharged  into  the  roof  of  his  mouth, 
and  pafied  into  his  brain. 

Mr. and  Mr. ,  two  young  men,  heirs  to  confiderable 

fortunes,  iliot  themfelves  at  the  age  of  four  or  five  and  twenty, 
without  their  friends  being  able  to  conjecture  any  caufe  for  thofe 
ram  actions.  One  of  them  I  had  long  known  to  exprefs  himfelf 
with  diffatisfaclion  of  the  world  ;  at  eighteen  years  of  age  he 
complained,  that  he  could  not  entertain  himfelf;  he  tried  to 
ftudy  the  law  at  Cambridge,  and  afterwards  went  abroad  for  a 
year  or  two  by  my  advice  ;  but  returned  difiatisfied  with  all 
things.  As  he  had  an  eruption  for  fome  years  on  a  part  of  his 
face,  which  he  probably  endeavoured  to  remove  by  external  ap- 
plications ;  I  was  induced  to  afcribe  his  perpetual  ennui  to  the 
pain  or  difagreeable  fenfation  of  a  difeafed  liver.  The  other 
young  gentleman  mot  himfelf  in  his  bed-room,  and  I  was  inform- 
ed that  there  was  found  written  on  a  fcrap  of  paper  on  his  table, 
"  I  am  impotent,  and  therefore  not  fit  to  live."  From  whence 
there  was  reafon  to  conclude,  that  this  was  the  hallucinatio  ma- 
niacalis,  the  delirious  idea,  which  caufed  him  to  deflroy  himfelf. 
The  cafe  therefore  belongs  to  mania  mutabilis,  and  not  to  tsedi- 
um  vitse. 

Thofe,  who  have  been  employed  during  the  firft  half  of  their 
lives  in  fome  very  active  bufmefs,  and  fuddenly  leave  it,  are  li- 
able to  this  kind  of  infanity,  and  even  to  fuicide  ;  of  which  I 
have  known  two  inftances,  one  of  them  a  Birmingham  manu- 
facturer, and  the  other  a  great  and  fuccefsful  commander.  This 
may  be  afcribed  to  the  accumulation  of  the  fenforial  power  of 
volition,  and  the  want  of  motive  to  exert  or  expend  it,  and 
which  thence  becomes  painful.  See  pain  of  cold  from  the 
want  of  ftimulus.  III.  2.  I.  17. 

This  may  afford  confolation  to  thofe,  whofe  fituation  in  life 
obliges  them  to  ufe  perpetual  indufhy  in  their  occupations  :  they 
may  fay,  that  as  they  have  been  long  in  the  habit  of  exerting 
much  voluntary  action,  they  muft  continue  to  employ  them- 
4felves  ;  other  wife  that  they  mall  link  into  low  fpirits,  as  it  is  call- 
ed, and  become  unhappy.  And  as  the  continuance  of  activity 
is  now  neceflary  to  their  happinefs,  they  had  better  employ 
themfelves  on  fuch  objects,  as  are  ufeful  to  themfelves  or  their 
connections,  than  to  confume  their  time,  and  mifapply  their  la- 
bour, in  card-playing,  wine-drinking,  or  fox-hunting,  which  are 
other  methods  of  relieving  ennui  or  the  irkfomenefs  of  life  by 
exertion,  and  confequent  expenditure  of  voluntary  power. 

>fs  degrees  of  this  malady  are  errcneoufly  termed  hypochon- 

driacifm, 


-iii.i.2.ii.    OF  VOLITION.  ^ 

driacifm,  fee  Clafs  1.  2.  4.  10.  by  the  people,  and  are  general- 
afcribed  to  the  want  of  voluntary  power,  or  of  induftry  ;  but 
I  believe  it  is  generally  owing  to  want  of  motive  or  ftimulus  | 
and  that  the  pain  attending  this  flate  of  our  ideas  or  mufcles  is 
occafioned  by  accumulation  of  voluntary  power,  as  above  men* 
tioned.  The  cure  of  this  difeafe,  is  popularly  known  to  confift 
in  any  kind  of  voluntary  exertion  of  the  mind,  or  of  the  body  \ 
one  of  our  poets  has  perfonified  hypocliondriacifm,  and  well  ad- 
vifes  the  ufe  of  exercife, or  exertion  to  oppofe  the  monfter,andfays> 

tt  Throw  bat  a  {fo'ne;  die  giant  dies." 

To  this  fhould  be  added,  that  thofc,  who  have  been  educated 
in  indolence,  do  not  find  or  feel  ennui,  or  the  pain  of  exiftencej, 
when  they  are  inactive  ;  like  our  domeftic  animals,  as  dogs  and 
cats,  who  deep  by  the  fire  without  inclination  to  hang  or  drown 
themfelves  ;  as  thefe  beings,  not  having  been  long  accuftomed 
to  expend  much  voluntary  power,  are  not  liable  to  much  accu-*- 
mulationof  it,  and  uneafinefs  in  confequence;  which  is  not  fo 
however  with  the  more  active  fquirrel  before  mentioned. 

But  on  the  contrary,  thofe,  whofe  education  has  induced  them 
16  ufe  much  voluntary  exertion,  and  have  afterwards  had  no 
aclive  employment,  as  happens  to  fome  unmarried  ladies,  are 
more  liable,  as  I  have  repeatedly  wimefTed,  to  this  malady  ;  art 
idea,  which  fhould  be  attended  to  in  female  education. 

Another  fource  of  ennui  or  taedium  vitse  is  alfo  derived  from 
wrong  education,  and  is  immediately  owing  to  the  want  of  ftim* 
ulus  rather  than  to  the  great  accumulation  of  voluntary  power ; 
and  is  liable  to  attend  fome  ladies  in  high  life,  whcfe  exertions 
during  their  early  years  were  excited  by  the  flattery  of  numer* 
ous  menial  fervants.  And  afterwards,  when  this  flattery  ceafes 
by  their  living  with  their  equals,  they  want  their  accuftomed 
motive  to  activity,  and  in  confequence  become  indolent  and  un* 
happy,  as  further  defcribed  in  Clafs  III*  2.  I.  8.  under  the  name 
of  Parefis  voluntaria» 

M.  M.  The  prevention  of  this  malady  mud  confift  in  the 
due  care  of  education.  Thofe  who  are  not  defigned  for  very 
active  life,  particularly  young  ladies,  {hould  not  be  forced  in 
their  early  years  to  ufe  too  violent  or  too  conftant  voluntary  ex- 
ertions- They  {hould  not  be  flattered  into  al!  their  exertions, 
but  ihould  be  taught  to  act  from  duty  to  themfelves  and  others, 
or  for  their  future  advantage  as  well  as  for  their  prefent  amu fo- 
ment. 

Some  reftraint  in  exhaufting  the  ufual  pleafures  of  the  world 
in  early  life  fhould  be  laid  on  young  men  of  fortune  5  and  after- 
wards the  pleafures  and  folitudes  of  a  matrimonial  liie  arc 

VOL,  II.  S  s  ftrongly 


322  DISEASES  CLASS  III.  i.  2. 1 2* 

ftrongly  to  be  recommended  ;  and  finally  the  cultivation  of  fci- 
erice,  as  of  chemiftry,  natural  philofophy,  natural  hiftory,  which 
fupplies  an  inexhauflible  fource  of  pleafurable  novelty,  and  re- 
lieves ennui  by  the  exertions  it  occafions. 

In  many  of  thefe  cafes,  when  irkfomenefs  of  life  has  been  the 
oftenfible  caufe  of  fuicide,  there  has  probably  exifted  a  maniacal 
hallucination,  a  painful  idea,  which  the  patient  has  concealed 
even  to  his  dying  hour  ;  except  where  the  mania  has  evidently 
arifen  from  hereditary  or  acquired  difeafe  of  the  membranous  or 
glandular  parts  of  the  fyftem. 

12.  Pulchritudinis  dejiderium.  The  lofs  of  beauty,  either  by 
difeafe,  as  by  the  fmall-pox,  or  by  age,  as  life  advances,  is  fome- 
tinie'3  painfully  felt  by  ladies,  who  have  been  much  flattered  on 
account  of  it.  There  is  a  curious  cafe  of  this  kind  related  in 
le  Sage's  Bachelor  of  Salamanca,  which  is  too  nicely  defcribed 
to  be  totally  imaginary. 

In  this  fituation  fome  ladies  apply  to  what  are  termed  cofmet- 
ics  under  various  names,  which  crowd  the  newfpapers.  Of 
thefe  the  white  has  deftroyed  the  health  of  thoufands  ;  a  calx, 
or  magiflery,  of  bifmuth  is  fuppofed  to  be  fold  in  the  mops  for 
this  purpofe  ;  but  it  is  either,  I  am  informed,  in  part  or  entirely 
white  lead  or  cerufla.  The  pernicious  effects  of  the  external 
uie  of  thofe  fatunline  applications  are  fpoken  of  iri  gutta  rofea, 
Clafs  II.  i.  4.  6.  The  real  calx  of  bifmuth  would  probably 
have  the  fame  ill  effect.  As  the  red  paint  is  prepared  from 
cochineal,  which  is  an  animal  body,  lefs  if  any  injury  arifes 
from  its  ufe,  as  it  only  lies  on  the  fkin  like  other  filth. 

The  tan  of  the  fkin  occafioned  by  the  fun  may  be  removed  by 
lemon  juice  evaporated  by  the  fire  to  half  its  original  quantity, 
or  by  diluted  marine  acid  ;  which  cleans  the  cuticle,  by  eroding 
its  furface,  but  requires  much  caution  in  the  application ;  the 
marine  acid  rnuft  be  diluted  with  water,  and  then  put  upon  the 
hand  or  face,  after  a  fecond  of  time,  as  foon  as  the  tan  difap- 
pears,  the  part  muft  be  wa'fhed  with  a  wet  towel  and  much 
warm  water.  Freckles  lie  too  deep  for  this  operation,  nor  are 
they  in  general  removable  by  a  blifter,  as  I  once  experienced. 
See  Clafs  I.  2.  2.  9. 

It  is  probable,  that  thofe  materials  which  flaiil  filk,  or  ivory, 
might  be  ufed  to  (lain  the  cuticle,  or  hair,  permanently  ;  as  they 
are  all  animal  fubftances.  But  I  do  not  know,  that  any  trials  of 
this  kind  have  been  made  on  the  fkin.  I  endeavoured  in  vain 
to  whiten  the  back  of  my  hand  by  marine  acid  oxygenated  by 
manganefe,  which  fo  inftantly  whitens  cotton. 

The  cure  therefore  muft  be  fought  from  moral  writers,  and 


CLASS  III.  i.  2.  13.      OF  VOLITION.  323 

the  cultivation  of  the  graces  of  the  mind,  which  are  frequently 
a  more  valuable  poffeflion  than  celebrated  beauty. 

13.  Paupertatis  timor.  The  fear  of  poverty  is  one  kind  of 
avarice  ;  it  is  liable  to  affect  people  who  have  left  off  a  profita- 
ble and  active  bufmefs  »  as  they  are  thus  deprived  of  their  ufual 
exertions,  and  are  liable  to  obferve  the  daily  expenditure  of  mon- 
ey, without  calculating  the  fource  from  whence  it  flows.  It  is 
alfo  liable  to  occur  with  a  fudden  and  unexpected  increafe  of 

fortune.     Mr. ,  a  furgeon,  about  fifty  years  of  age,  who 

was  always  rather  of  a  parfimonious  difpofition,  had  a  large 
houfe,  with  a  fortune  of  forty  thoufand  ppunds,  left  him  by  a 
diftant  relation  5  and  in  a  few  weeks  became  infane  from  the 
fear  of  poverty,  lamenting  that  he  fhould  die  in  a  jail  or  a  work- 
houfe.  He  had  left  off  a  laborious  country  bufmefs,  and  the 
daily  perception  of  profit  in  his  books  j  he  alfo  now  faw  greater 
expenfes  going  forwards  in  his  new  houfe,  than  he  had  been 
accuftomed  to  obferve,  and  did  not  fo  diftinctly  fee  the  fource 
of  fupply  ;  which  feems  to  have  occafioned  the  maniacal  hallu- 
cination.— This  idea  of  approaching  poverty  is  a  very  frequent 
and  very  painful  difeafe,  fo  as  to  have  induced  many  to  become 
fuicicjes,  who  were  in  good  circumflances  ;  more  perhaps  than 
any  other  maniacal  hallucination,  except  the  fear  of  Hell. 

The  covetoufnefs  of  age  is  more  liable  to  affect  fingle  men, 
than  thofe  who  have  families  ;  though  an  accumulation  of  wealth 
would  feem  to  be  more  defirable  to  the  latter.  But  an  old  man 
in  the  former  fituation,  has  no  perfonal  connections  to  induce 
him  to  open  his  purfe  ;  and  having  loll  the  friends  of  his  youth, 
and  not  eafily  acquiring  new  ones,  feels  himfelf  alone  in  the 
world  :  feels  himfelf  unprotected,  as  his  ilrengtji  declines,  and 
is  thus  led  tq  depend  for  affiftance  on  money,  and  on  that  ac- 
count wimes  to  accumulate  it.  Whereas  the  father  of  a  family 
has  not  only  thofe  connections^  which  demand  the  frequent  ex- 
penditure of  money,  but  feels  a  confojation  in  the  friendfhip  of 
his  children,  when  age  may  render  their  good  offices  neccffary 
to  him. 

M.  M.  I  have  been  well  informed  of  a  medical  perfon  in 
good  circumftances  in  London,  who  always  carries  an  account 
of  his  affairs,  as  debtor  and  creditor,  in  his  pocket-book  j  and 
looks  over  it  frequently  in  a  day,  when  this  diieafe  returns  upon 
him ;  and  thus,  by  counteracting  the  maniacal  hallucination, 
wifely  prevents  the  increafe  of  his  infanity.  Another  medical 
perfon,  in  London,  is  faid  to  have  cured  himfelf  of  this  difeafe 
by  ftudying  mathematics  with  great  attention  \  which  exertion 
of  the  mind  relieved  the  pain  of  the  maniacal  hallucination. 

Many  moral  writers  have  ftigmatifed  this  infanity  \  the  covet- 
ous, 


3  ^  DISEASES  CL^SS  HI.  t.  a.  i^ 

ous,  they  fay,  commit  crimes  and  mortify  themfelves  without 
Jiopes  of  reward  5  and  thus  become  miferable  both  in  this  workf 
and  the  next.  Thus  Juvenal ; 

Cum  furor  haud  dubius,  cum  fit  manifefta  phrenitis, 
U't  locuples  moriaris.,  egenti  vivere  fato  1 

The  covetous  man  thought  he  'gave  good  advice  to  the; 
fpendthrift,  when  he  faid,  «  Live  like  me/'  who  well  anfweredi 
hjrn. 


Like  you,  Sir  John  ? 


^  That  I  can  do,  when  all  I  have  is  gone  1" 

Pan 

14.  Leihi  timer.  The  fear  of  death  perpetually  employs  the 
thoughts  of  thefe  patients  :  hence  they  are  devifing  new  medi- 
cines, and  applying  to  phyficians  and  quacks  without  number* 
Jt  is  confounded  with  hypochondriafis,  Clafs  I.  2.  3.  9.  in  pop^ 
ular  converfation,  but  is  in  reality  an  infanity. 

A  young  gentleman,  whom  I  adyifed  to  go  abroad  as  a  cure 
for  this  difeafe,  aflured  me,  that  during  the  three  years  he  was 
In  Italy  and  France  he  never  paffed  a  quarter  of  an  hour  with- 
out fearing  he  mould  die.  But  he  has  now  for  above  twenty 
years  experienced  the  contrary. 

The  fufferers  under  this  malady  are  generally  at  once  difcov- 
erable  by  their  telling  you,  amidft  an  unconnected  defcription, 
of  their  complaints,  that  they  are  neverthelefs  not  afraid  of  dy- 
ing. They  are  alio  eafily  led  to.  complain  of  pains  in  almoft  any 
part  of  the  body,  and  are  thus  foon  difcovered- 

M-  M»  As  the  maniacal  hallucination  has  generally  arifen  in 
early  infancy  from  fome  dreadful  account  of  the  ilruggles  and 
pain  of  dying,  I  have  fometimes  obferved,  that  thefe  patients 
have  received  great  confolation  from  the  inftauces  I  have  re- 
lated to  them  of  people  dying  without  pain.  Some  of  thefe, 
which  I  think  curious,  I  {hall  concifely  relate,  as  a  part  of  the 
niethod  of  cure, 

Mr.  * ,  an  elderly  gentleman,  had  fent  for  me  one  whole 

day  before  I  could  attend  him ;  on  my  arrival  he  faid  lie  was 
glad  to  fee  me,  but  that  he  was  now  quite  well,  except  that  ho 
was  weak,  but  had  had  a  pain  in  his  bowels  the  day  before.  He 
then  lay  in  bed  with  his  legs  cold  up  to  the  kneesj  his  hands 
•and  arms  cold,  and  his  pulfe  fcarcely  difcernible,  and  died  in 
about  fix  hours.  Mr.  — •. — ,  another  gentleman  about  fixty,  lay  in 
the  aft  of  dying,  with  difficult  refpiration  like  groaning,  but  in  a 
kind  of  ftupor  or  coma  vigil,  and  every  ten  or  twelve  minutes* 
while  I  fat  by  hirrjj  he.  wakedj  looked  up*  a.n.4  faida  <«  who  is  it 


CLASS  III.  i.  2.  IS-        OF  VOLITION. 

groans  fo,  I  am  fure  there  is  fomebody  dying  in  the  room,"  and 
Then  funk  again  into  a  kind  of  ileep.  From  thefe  two  cafes 
there  appeared  to  be  no  pain  in  the  aft  of  dying,  which  may 
afford  confolation  to  all,  but  particularly  to  thofe  who  are  afflict- 
ed with  the  fear  of  death. 

15.  Orcitimor.  The  fear  of  Hell.  Many  theatric  preachers 
among  the  Methodifts  fuccefsfully  infpire  this  terror,  and  live 
comfortably  upon  the  folly  of  their  hearers.  In  this  kind  of 
madnefs  the  poor  patients  frequently  commit  fiucide  ;  although 
they  believe  they  run  headlong  into  the  Hell,  which  they  dread  ! 
Such  is  the  power  of  oratory,  and  fuch  the  debility  of  the  hu- 
man underftanding  ! 

Thofe,  who  fuffer  under  this  infanity,  are  generally  the  moft 
innocent  and  harmlefs  people  5  who  are  then  liable  to  accufe 
themfelves  of  the  greateft  imaginary  crimes,  and  have  fo  much 
intellectual  cowardice,  that  they  dare  not  reaibn  about  thofe 
things,  which  they  are  directed  by  their  prieils  to  believe,  how-* 
ever  contradictory  to  human  apprehenfion,  or  derogatory  to  the 
great  Creator  of  all  things.  The  maniacal  hallucination  at  length 
becomes  fo  painful,  that  the  poor  infane  flies  from  life  to  be» 
pome  free  from  it. 

M.  M.  Where  the  intellectual  cowardice  is  great,  the  voice 
of  reafon  is  ineffectual  j  but  that  of  ridicule  may  fave  many 
from  thofe  mad-making  doctors ;  though  it  is  too  weak  to  cure 
thofe,  who  are  already  hallucinated.  Footed  Farces  are  recenv 
mended  for  this  purpofe, 

1 6.  Satyriajts,  An  ungovernable  defire  of  venereal  indul- 
gence. The  remote  caufe  is  probably  the  ilimulus  of  the  fe- 
rnen  ;  whence  the  phallus  becomes  diftended  with  blood  by  the 
arterial  propultion  of  it  being  more  ftrongly  excited  than  the 
correfpondent  venous  abforption.  At  the  fame  time  a  new  fenfe 
is  produced  in  the  other  termination  of  the  urethra  ;  which,  like 
itching,  requires  fome  exterior  friction  to  facilitate  the  removal 
of  the  caufe  of  the  mamacal  actions,  which  may  probably  be  in- 
creafed  in  thofe  cafes  by  fome  afTociatecl  hallucinations  of  ideas, 
It  differs  from  priapifmus  chronicus  in  the  deilre  of  its  appro-* 
priated  object,  which  is  not  experienced  in  the  latter,  Chfs  I. 
I.  4.  6.  and  from  the  priapifmus  amatorius,  Clafs  II.  j.  7,  9.  in 
the  maniacal  actions  in  confequence  of  defire.  The  furor  ute« 
rinus,  or  nymphomania,  is  a  fimilar  difcafe, 

M.  M.  Venefection.     Cathartics.     Torpentia.     Marriage. 
17.  /r/7.     Anger  is  caufed  by  offended  pride.     We  are  not 
angry  at  breaking  a  bone,  but  become  quite  infane  from  the 
fmulleft  ftrcke  of  a  whip  from  an  inferior/  Ira  furor  brcvis.  An- 
ger is  not  only  itfelf  a  temporary  roadnefs,  but  is  a  frequent  at- 
tend ar.t 


326  DISEASES          CLASS  III.  i.  2.  iS. 

tendant  on  other  infancies,  and  as,  whenever  it  appears,  it  dif- 
tjnguifhes  infanity  from  delirium,  it  is  generally  a  good  fign  in 
fevers  with  debility. 

An  injury  voluntarily  inflicted  on  us  by  others  excites  our  ex- 
ertions of  felf-defence  or  of  revenge  againft  the  perpetrator  of 
it ;  but  anger  does  not  fucceed  in  any  great  degree  unlefs  our 
pride  is  offended  ;  this  idea  is  the  maniacal  hallucination,  tha 
pain  of  which  fometimes  produces  fuch  violent  and  general  ex- 
ertions of  our  mufcles  and  ideas,  as  to  difappoint  the  revenge 
we  meditate,  and  vainly  to  exhauft  our  fenforial  power.  Hence 
angry  people,  if  not  further  excited  by  difagreeable  language, 
are  liable  in  an  hour  or  two  to  become  humble,  and  forry  for  their 
violence,  and  willing  to  make  greater  conceflions  than  required. 

M.  M.  Be  filent  when  you  feel  yourfelf  angry.  Never  ufe 
loud  oaths,  violent  upbraidings,  or  ftrong  expreflions  of  counte- 
nance, or  gefticulations  of  the  arms,  or  clenched  fifts  ;  as  thefe 
by  their  former  aflbciations  with  anger  will  contribute  to  in- 
creafe  it.  I  have  been  told  of  a  fergeant  or  corporal,  who  be- 
gan moderately  to  cane  his  foldiers,  when  they  were  awkward 
in  their  exercife,  but  being  addicted  to  fwearing  and  coarfe  lan- 
guage, he  ufed  foon  to  enrage  himfelf  by  his  own  expreflions  of 
anger,  till  toward  the  end  he  was  liable  to  beat  the  delinquents 
unmercifully. 

1 8.  Rabie*.  Rage.  A  defire  of  biting  others,  moft  frequent- 
ly attendant  on  canine  madnefs.  Animals  in  great  pain,  as  in 
the  colica  faturnina,  are  fa^d  to  bite  the  ground  they  lie  upon, 
and  even  their  own  ficfh.  I  have  feen  patients  bite  the  attend- 
ants, and  even  their  own  arms,  in  the  epilepfia  dolorifica.  It 
feems  to  be  an  exertion  to  relieve  pain,  as  explained  in  Se&. 
XXXIV.  1.3.  The  dread  of  water  in  hydrophobia  is  occafion- 
ed  by  the  repeated  painful  attempts  to  fwallow  it,  and  is  there-, 
fore  not  an  eiTemial  or  original  part  of  the  difeale  called  canine 
madnefs.  See  Clafs  III.  I.  i.  15. 

There  is  a  mania  reported  to  exift  in  fome  parts  of  the  eaft, 
In  which  a  man  is  faid  to  run  a  muck ;  and  thefe  furious  mani- 
acs are  believed  to  have  induced  their  calamity  by  unlucky  gam- 
ing, and  afterwards  by  taking  large  quantities  of  opium  •,  whence 
the  pain  of  defpair  is  joined  with  the  energy  of  drunkennefs  -, 
they  are  then  faid  to  fally  forth  into  the  moil  populous  ftreets, 
and  to  wound  and  flay  all  they  meet,  till  they  receive  their  own 
death,  which  they  defire  to  procure  without  the  greater  guilt, 
as  they  fuppofe  of  fuicide. 

M.  M.  When  there  appears  a  tendency  to  bite  in  the  pain- 
ful epilepfy,  the  end  of  a  rolled  up  towel,  or  a  wedge  of  foft 
wood,,  ftiould  be  put  into  the  mouth  of  the  patient.  As  a  bui- 

let 


CLASS  UI.  i.  2.  19.      OF  VOLITION.  327 

let  is  faid  fometimes  to  be  given  to  a  foldier,  who  is  to  be  ie- 
verely  flogged,  that  he  may  by  biting  it  better  bear  his  punifli- 
ment. 

i  p.  Citta.  A  defire  to  fwallow  indigeftible  fubftances.  I 
once  faw  a  young  lady,  about  ten  years  of  age,  who  filled  her 
ftomach  with  the  earth  out  of  a  flower-pot,  and  vomited  it  up 
with  fmall  (tones,  bits  of  wood,  and  wings  of  infects  arnongft  it. 
She  had  the  bombycinous  complexion,  and  looked  like  a  chloro- 
tic  patient,  though  fo  young  ;  this  generally  proceeds  from  an 
acid  in  the  ftomach. 

M.  M.  A  vomit.  Magnefia  alba.  Armenian  bole.  Rhu- 
barb. Bark.  Steel.  A  blifter.  See  Clafs  I.  2.  4.  5. 

20.  Averfion   to  food.     This  may  arife,  without 
difeafe  of  the  ftomach,  from  connecting  naufeous  ideas  to  our 

ufual  food,  as  by  calling  a  ham  a  hog's  a .     This  madnefs 

is  much  inculcated  by  the  ftoic  philolophy.     See  Antoninus* 
Meditations.     See  two  cafes  of  patients  who  refufed  to  take 
nourimment,  Clafs  III.   i.   2.    i. 

Averfions  to  peculiar  kinds  of  food  are  thus  formed  early  in 
life  by  aflbciation  of  iome  maniacal  hallucination  with  them,  I 
remember  a  child,  who  on  tafting  the  griftle  of  fturgeon,  afked 
what  grift le  was  ?  And  being  told  it  was  like  the  divifion  of 
a  man's  nofe,  received  an  ideal  hallucination  ;  and  for  twenty 
years  afterwards  could  not  be  perfuaded  to  tafte  fturgeon. 

The  great  fear  or  averfion,   which  fome  people  experienc 
the  fight  of  fpiders,  toads,  crickets,  and  the  like,  have  generally- 
had  a  fimilar  origin. 

M.  M.  Afibciate  agreeable  ideas  with  thofe  which  difguil ; 
as  call  a  fpider  ingenious,  a  frog  clean  and  innocent  j  and  reprefs 
all  expreffions  of  difguft  by  the  countenance,  as  fuch  exprefTions 
contribute  to  preferve,  or  even  to  increafe  the  energy  of  the  ideas 
aflbciated  with  them  ;  as  mentioned  above  in  Species  17.  Ira. 

2 1 .  Syphilis  wiaginarm.     The  fear  that  they  are  infeded  v 
the  venereal  difeaie,  when  they  have  only  deferved  it,  is  a  very 
common  infanity  amongft  modeft  young  men  ;   and  is  not  to  be 
cured  without  applying  artfully  to  the  mind  ;  a  little  mercury 
muft  be  given,  and  hopes  of  a  cure  added  weekly  and  gradually 
by  interview  or  correfpondence  for  fix  or  eight  weeks.     Many 
of  thefe  patients  have  been  repeatedly    ialivated  without  curing 
the  mind ! 

22.  Pfcra  itnaginaria.     I  have  twice  feen   an  imaginary  :. 
and  twice  an  imaginary  diabetes,  where  there  was  not  the 
veftige  of  either  of  thofe  difeaies,  and  once  an  ir 

nefs,  where  the  patient  heard  perfectly  well.    In  all  thefe  caf. 
hallucinated  idea  is  fo  powerfully  excited,  that  it  is   nor  to  be 

<iged 


CiSEASES  CLASS  tti.i.t.434> 

changed  Suddenly  by  ocular  fenfation,  or  reafotl.  Yet  gfeaf, 
perfeverance  in  the  frequently  preferring  contrary  ideas  will 
fometimes  flowly  remove  this  hallucination,  or  in  great  length 
of  time  oblivion,  or  forgetfulnefs,  performs  a  cure>  by  other 
means  in  vain  attempted. 

23.  Tabes imaginar'm.     This  imaginary  difeafe,  or  hallucina« 
tion,  is  Cdufed  by  the  fuppofed  too  great  frequency   of  parting 
with  the   femen,  and  had  long  impofed  upon  the   phyfician  a? 
well  as  the  patient,  till  Mr.  John  Hunter  rirft  endeavoured  to 
(hew,  that  in  general  the   morbid  effects  of  this  pollution  were 
in  the  imagination ;  and  that  thofe  were  only  liable  to  thofe  ef* 
fec~t.s  in  general,  who  had  been  terrified  by  the  vilianous  books, 
which  pretend  to  prevent  or  to  cure  it,  but  which  were  purpofely 
written  to  vend  fome  quack  medicine.     Moft  of  thofe  unhappy 
patients,  whom  I  have   feen,  had  evidently  great  impreflion  of 
fear  and  feJf-condemnatiott  on  their  minds,  and  might  be  led  to 
make  contradictory  complaints  in  almoft  any   part  of  the  body, 
and  if  their  confeflions  could  be  depended  on,  had  not  ufed  this 
pollution  to  any  great  excefs. 

M.  M.  i.  Allure  them  if  the  lofs  of  the  femen  happens  but 
twice  a  week,  it  will  not  injure  them.  ^.  Marry  them.  Thd 
lad  is  a  certain  cure  ;  whether  the  difeafe  be  real  or  imaginary^ 
Cold  partial  bath,  and  aftringent  medicines  frequently  taken,  on- 
ly recal  the  mind  to  the  difeafe,  or  to  the  delinquency  ;  and 
thence  increafe  the  imaginary  effects  and  the  real  caufe,  if  fuch 
exifrs.  Mr.  — —  deftroyed  himfelf  to  get  free  from  the  pain 
of  fear  of  the  fuppofed  ill  confluences  of  felf-pollution,  without 
any  other  apparent  difeafe  ;  whofe  parents  I  had  in  vain  advifed 
to  marry  him,  if  poflible. 

24.  Sympathta  aliena*     Pity.     Our  fynipathy  with  the   pleaf- 
ures  and  pains  of  others  diflinguifhes  men  from  other  animals } 
and  is  probably  the  foundation  of  v/hat  is  termed  our  moral  fenfe  \ 
and    the  fource   of   all  our  virtues.     See   Sect.  XXII.  3.  3. 
When  our  fympathy  with  thofe  miferies  of  mankind,  which  we 
cannot  alleviate,  rifes  to  excefs,  the  mind  becomes  its  own  tor- 
mentor ;  and  we    add  to  the   aggregate  fum  of  human  mifery, 
\vhich  we  ought  to  labour  to  diminifh  ;  as  in  the  following  elo» 
quent  lamentation  from   Akenfide's  Pleafures  of  Imagination, 
Book  II.  1.  200. 


Dark, 


As  midnight  ftorms,  the  fcene  of  human  things 
Appear'd  before  me  ;  deferts,  burning  fands, 
Where  the  parch'd  adder  dies  ;  the  frozen  fouth  \ 
And  defolation  blafting  all  the  weft 
With  rapine  and  with  murdrr.     Tyrant  power 
Here  fits  enthroned  in  blooa  ;  the  baleful 


CLASS  III.  i.  2.  25.        OF  VOLITION. 

Of  fuperftition  there  infe£  the  fides, 

And  turn  the  fun  to  horror.     Gracious  Heaven  ! 

What  is  the  life  of  man  ?     Or  cannot  thefe, 

Npt  thcfe  portents  thy  awful  will  fuffice  ? 

That,  propagated  thus  beyond  their  fcope, 

They  rife  to  act  their  cruelties  anew 

In  my  affii;$ed  bofom,  thus  decreed 

The  univerfal  fenfitive  of  pain, 

The  wretched  heir  of  evils  not  its  own ! 

A  poet  of  antiquity,  whofe  name  I  do  not  recoiled,  is  faid  to 
have  written  a  book  defcribing  the  miferies  of  the  world,  and  to 
have  deftroyed  himfelf  at  the  conclufion  of  his  tafk.  This  fym- 
pathy,  with  all  fenfitive  beings,  has  been  carried  fo  far  by  fome 
individuals,  and  even  by  whole  tribes,  as  the  Gentoos,  as  not 
only  to  reftrain  them  from  killing  animals  for  their  fupport,  but 
even  to  induce  them  to  permit  infects  to  prey  upon  their  bodies. 
Such  is  however  the  condition  of  mortality,  that  the  fir  ft  law  of 
nature  is,  "  Eat  or  be  eaten."  We  cannot  long  exift  without 
the  deflruction  of  other  animal  or  vegetable  beings,  either  in 
their  mature  or  their  embryon  ftate.  Unlefs  the  fruits,  which 
furround  the  feeds  of«fome  vegetables,  or  the  honey  ftolen  from 
them  by  the  bee,  may  be  faid  to  be  an  exception  to  this  affer- 
tion.  See  Botanic  Garden,  P.  I.  Cant.  1. 1.  278.  Note.  Hence, 
from  the  neceffity  of  our  nature,  we  may  be  fuppofed  to  have  a 
right  to  kill  thofe  creatures,  which  we  want  to  eat,  or  which 
want  to  eat  us.  But  to  deftroy  even  infects  wantonly  {hews  an 
unreflecting  mind  or  a  depraved  heart. 

Neverthelefs  mankind  may  be  well  divided  into  the  felfifh  and 
the  focial ;  that  is,  into  thofe  whofe  pleafures  arife  from  grati- 
fying their  appetites,  and  thofe  whofe  pleafures  arife  from  their 
fympathifmg  with  others.  And  according  to  the  prevalence  of 
thefe  oppofing  propenfities  we  value  or  diflike  the  poffefTor  of 
them. 

In  conducting  the  education  of  young  people,  it  is  a  nice 
matter  to  infpire  them  with  fo  much  benevolent  fympathy,  or 
compaflion,  as  may  render  them  good  and  amiable  ;  and  yet  not 
fo  much  as  to  make  them  unhappy  at  the  fight  of  incurable  dif- 
trefs.  We  (hould  endeavour  to  make  them  aiive  to  fympathize 
with  all  remediable  evils,  and  at  the  fame  time  to  arm  them  with 
fortitude  to  bear  the  fight  of  fuch  irremediable  evils,  as  the  acci- 
dents of  life  muft  frequently  prefent  before  their  eyes.  About 
this  I  have  treated  more  at  large  in  a  plan  for  the  conduct  of  a 
board ing-fchool  for  ladies,  which  I  intend  to  publim  in  the  courfe 
of  the  next  year. 

25.  Editcatio  heroica.  From  the  kinds  and  degrees  of  infan- 
ities  already  enumerated,  the  reader  will  probably  recolkft  ma- 

VOL.  II.  T  T  ny 


33®  DISEASES  CLASS  III.  i.  2. 25. 

ny  more  from  his  own  obfervation  ;  he  will  perceive  that  all 
extraordinary  exertions  of  voluntary  action  in  confequence*  of 
fome  falfe  idea  or  hallucination,  which  ftrongly  affects  us,  may 
philofophically,  though  not  popularly,  be  termed  an  infanity  ; 
he  will  then  be  liable  to  divide  thefe  voluntary  exertions  into 
difagreeable,  pernicious,  deteftable,  or  into  meritorious,  delecta- 
ble, and  even  amiable,  infanities.  And  will  laftly  be  induced 
to  conceive,  that  a  good  education  confifts  in  the  art  of  produc- 
ing fuch  happy  hallucinations  of  ideas,  as  may  be  followed  by 
fuch  voluntary  exertions,  as  may  be  termed  meritorious  or  ami- 
able infanities. 

The  old  man  of  the  mountain  in  Syria,  who  governed  a  fmall 
nation  of  people  called  Aflaflines,  is  recorded  thus  to  have  edu- 
cated thofe  of  his  army  who  were  defigned  to  aflaflinate  the 
princes  with  whom  he  was  at  war.  A  young  man  of  natural 
activity  was  chofen  for  the  purpofe,  and  thrown  into  a  deep 
fleep  by  opium  mixed  with  his  food ;  he  was  then  carried  into 
a  garden  made  to  reprefent  the  paradife  of  Mahomet,  with  flow- 
ers of  great  beauty  and  fragrance,  fruits  of  delicious  flavour,  and 
beautiful  Houries  beckoning  him  into  ihe  fhades.  After  a 
while,  on  being  a  fecond  time  ftupified  with  opium,  the  young 
enthufiaft  was  reconveyed  to  luYapartment ;  and  on  the  next  day 
was  aflured  by  a  prieft,  that  he  was  defigned  for  fome  great  ex- 
ploit, and  that  by  obeying  the  commands  of  their  prince,  im- 
mortal happinefs  awaited  him. 

Hence  it  is  eafy  to  collect  how  the  firft  impreflions  made  on 
us  by  accidental  circumftances  in  our  infancy  continue  through 
life  to  bias  our  affect  ions,  or  miflead  our  judgments.  One  of 
my  acquaintance  can  trace  the  origin  of  his  own  energies  of  ac- 
tion from  fome  fuch  remote  fources,  which  juftifies  the  obferva- 
tion of  M.  RouiTeau,  that  the  feeds  of  future  virtues  or  vices 
are  oftener  fown  by  the  mother  than  the  tutor. 


CLASS  III.  2.1.  OF  VOLITION.  3  3 ' 

ORDO  II. 

Decreafed  Volition. 

GENUS  I. 
With  decreafed  AElions  of  the  Mufcles. 

OUR  mufcles  become  fatigued  by  long  contra&ion,  and  ceafc 
for  a  time  to  be  excitable  by  the  will ;  owing  to  exhauftion  of 
the  fenforial  power,  which  refides  in  them.  After  a  fhort  inter- 
val of  relaxation  the  mufcle  regains  its  power  of  voluntary  con- 
traction 5  which  is  probably  occafioned  by  a  new  fupply  of  the 
fpirit  of  animation.  In  weaker  people  thefe  contractions  ceafe 
fooner,  and  therefore  recur  more  frequently,  and  are  attended 
with  fliorter  intervals  of  relaxation,  as  exemplified  in  the  quick- 
nefs  of  the  pulfe  in  fevers  with  debility,  and  in  the  tremors  of 
the  hands  of  aged  or  feeble  people. 

After  a  common  degree  of  exhauftion  of  the  fenforial  power 
in  a  mufcle,  it  becomes  again  gradually  reftored  by  the  reft  of 
the  mufcle,  and  even  accumulated  in  thofe  mufcles,  which  are 
moft  frequently  ufed  ;  as  in  thofe  which  conftitute  the  capilla- 
ries of  the  fkin  after  having  been  rendered  torpid  by  cold.  But 
in  thofe  mufcles,  which  are  generally  obedient  to  volition,  as 
thofe  of  locomotion,  though  their  ufual  quantity  of  fenforial 
power  is  reftored  by  their  quiefcence,  or  in  fleep  (for  ileep  af- 
fecls  thefe  parts  of  the  fyftem  only),  yet  but  little  accumulation 
of  it  fucceeds.  And  this  want  of  accumulation  of  the  fenforial 
power  in  thefe  mufcles,  which  are  chiefly  fubfervient  to  voli- 
tion, explains  to  us  one  caufe  of  their  greater  tendency  to  para- 
lytic affection. 

It  muft  be  obferved,  that  thofe  parts  of  the  fyftem,  which 
have  been  for  a  time  quiefcent  from  want  of  ftimulus,  as  the 
veflels  of  the  fkin,  when  expofed  to  cold,  acquire  an  accumula- 
tion of  fenforial  power  during  their  inactivity ;  but  this  does 
not  happen  at  all,  or  in  much  lefs  quantity,  from  their  quief- 
cence after  great  expenditure  of  fenforial  power  by  a  previous 
exceflive  ftimulus,  as  after  intoxication.  In  this  cafe  the  muf- 
cles or  organs  of  fenfe  gradually  acquire  their  natural  quantity 
of  fenforial  power,  as  after  fleep  ;  but  not  an  accumulation  or 
iuperabundance  of  it.  And  by  frequent  repetitions  of  exhauf- 
tion by  great  ftimulus,  thefe  veflels  ceafe  to  acquire  their  whole 
natural  quantity  of  fenforial  power ;  as  in  the  fcirrhous  ftom- 
ach,  and  fcirrhous  liver,  occafioned  by  the  great  and  frequent 

ftimulus 


3  3  *  DISEASES  CLASS  III.  2.  i  .  i  . 

ftimulus  of  vinous  fpirit  ;  which  may  properly  be  termed  irrita- 
tive paralyfis  of  thofe  parts  of  the  fyftem. 

In  the  fame  manner  in  common  palfies  the  ina&ion  of  the 
paralytic  mufcle  feems  not  to  be  owing  to  defecT:  of  the  ftimu- 
lus of  the  will,  but  to  exhauftion  of  fenforial  power.  Whence 
it  frequently  folio  ws^great  exertion,  as  in  Seel:.  XXXIV.  i.  7. 
Thus  ibme  parts  of  the  fyftem  may  ceafe  to  obey  the  will,  as  in 
common  paralyfis  •,  others  may  ceafe  to  be  obedient  to  fenfation, 
as  in  the  impotency  of  age  ;  others  to  irritation,  as  in  fchirrous 
vifcera  j  and  others  to  aifociation,  as  in  impediment  of  fpeech  \ 
yet  though  all  thefe  may  become  inexcitatye,  or  dead,  in  refpedi 
to  that  kind  of  ftimulus,  which  has  previoufly  exhaufted  themf 
whether  of  volition,  or  fenfation,  or  irritation,  or  aflbciation, 
they  may  ftill  in  many  cafes  be  excited  by  the  others. 

SPECIES. 

i  .  LaJJltudo.  Fatigue  or  wearinefs  after  much  voluntary  ex- 
ertion. From  the  too  great  expenditure  of  fenforial  power  the 
mufcles  are  with  difficulty  brought  again  into  voluntary  con- 
trattion  j  and  feem  to  require  a  greater  quantity  or  energy  of  vo- 
lition for  this  purpofe.  At  the  fame  time  they  ftill  remain  obe- 
dient to  the  ftimulus  of  agreeable  fenfation,  as  appears  in  tired 
4anc  rs  rinding  a  renovation  of  their  aptitude  to  motion  on  the 
acquisition  of  an  agreeable  partner  ;  or  from  a  tired  child  riding 
on  a  gold-headed  cane,  as  in  Seel:.  XXXIV.  2.  6.  Thefe  muf- 
cles are  like  wife  ftill  obedient  to  the  fenforial  power  of  aflbcia- 
tion,  becaufe  the  motions  when  thus  excited,  are  performed  in 
their  defigned  directions,  and  are  not  broken  into  variety  of  gef- 
ticulation,  as  in  St.  Vitus's  dance. 

A  laflitude  likewife  frequently  occurs  with  yawning  at  the 
beginning  of  ague-fits  ;  where  the  production  of  fenforial  pow- 
er in  the  brain  is  lefs  than  its  expenditure.  For  in  this  cafe  the 
torpor  may  either  originate  in  the  brain,  or  the  torpor  of  fome 
diftant  parts  of  the  iyftem  may  by  fympathy  affect  the  brain, 
though  in  a  lefs  proportionate  degree  than  the  parts  primarily 


2.  Vacillatio  fenilis.  Some  elderly  people  acquire  a  fee-faw 
motion  of  their  bodies  from  one  fide  to  the  other,  as  they  fit, 
like  the  ofcillation  of  a  pendulum.  By  thefe  motions  the  muf- 
cles, which  preferve  the  perpendicularity  of  the  body,  are  alter- 
nately quiefcent,  and  exerted  ;  and  are  thus  lefs  liable  to  fatigue 
or  exhauftion.  This  therefore  refembles  the  tremors  of  old 
people  above  mentioned,  and  not  thofe  fpafmodic  movements  ot 
the  face  or  lirnbs,  which  are  called  tricks,  defcribed  in  Clafs  IV. 

3- 


CLASS  III.  2.  i.  3.        OF  VOLITION. 

3.2.  2.  which  originate  from  excefs  of  fenforial  power,  or  from 
efforts  to  relieve  difagreeable  fenfation,  and  are  afterwards  con- 
tinued by  habit. 

3.  Tremor  fenilis.     Tremor  of  old  age  confifts  of  a  perpetual 
trembling  of  the  hands,  or  of  the  head,  or  of  other  mufcles, 
when  they  are  exerted  •,  and  is  erroneoufly  called  paralytic  •,  and 
feems  owing  to  the  fmall  quantity  of  animal  power  rending  in 
the  mufcular  fibres.     Thefe  tremors  only  exill  when  the  affect- 
ed mufcles  are  excited  into  action,  as  in  lifting  a  glafs  to  the 
mouth,  or  in  writing,  or  in  keeping  the  body  upright  •,  and  ceafc 
again,  when  no  voluntary  exertion  is  attempted,  as  in  lying 
down.     Hence  thefe  tremors  evidently  originate  from  the  too 
quick  exhauftion  of  the  leffened  quantity  of  the  fpirit  of  anima- 
tion.    So  many  people  tremble  from  fear  or  anger,  when  too 
great  a  part  of  the  fenforial  power  is  exerted  on  the  organs  of 
fenfe,  fo  as  to  deprive  the  mufcles,  which  fupport  the  body 
creel,  of  their  due  quantity. 

4.  Erachiorum  paral\fis.     A  numbnefs  of  the  arms  is  a  fre- 
quent fymptom  in  hydrops  thoracis,  as  explained  in  Clafs  I.  2. 
3.14.  and  in  Seel.  XXIX.  5.  2.  ;  it  alfo  accompanies  the  afthma 
dolorificum,  Clafs  III.  i.  i.  11.  and  is  owing  probably  to  the 
fame  caufe  in  both.     In  the  colica  farurnina  a  paralyfis  affects 
the  wrifts,  as  appears  on  the  patient  extending  his  arm  horizon- 
tally with  the  palm  downwards,  and  is  often  attended  with  a  tu- 
mor on  the  carpal  or  metacarpal  bones.     See  Clafs  IV.  2.  2.  10* 
and  I.  2.  4.  8. 

Mr.  M ,  a  miner  and  well-Tinker,  about  three  years  ago, 

loft  the  power  of  contracting  both  his  thumbs  ;  the  balls  or  muf- 
cles of  the  thumbs  are  much  emaciated,  and  remain  paralytic. 
He  afcribes  his  difeafe  to  immerfing  his  hands  too  long  in  cold 
water  in  the  execution  of  his  bufmeis.  He  fays  his  hands  had 
frequently  been  much  benumbed  before,  fo  that  he  could  not 
without  difficulty  clench  them  ;  but  that  they  recovered  their 
motion,  as  loon  as  they  began  to  glow,  after  he  had  dried  and 
covered  them. 

In  this  cafe  there  exifted  two  injurious  circumflances  of  dif- 
ferent kinds  •,  one  the  violent  and  continued  action  of  the  muf- 
cles, which  deftroys  by  exhaufting  the  fenforial  power ;  and  the 
other,  the  application  of  cold,  which  deftroys  by  defect  of  ftim- 
ulus.  The  cold  feems  to  have  contributed  to  the  paralyfis  by- 
its  long  application,  as  well  as  the  continued  exertion  j  but  as 
during  the  torpor  occafioned  by  the  expofure  to  cold,  if  the  de- 
gree of  it  be  not  fo  great  as  to  extinguish  life,  the  ienforial  pow- 
er becomes  accumulated  ;  there  isreafon  to  believe,  that  the  ex- 
pofing  a  paralytic  limb  to  the  cold  for  a  certain  time,  as  by  cov- 
ering 


334  DISEASES  CLASS  III.  2.  i.  5. 

ering  it  with  fnow  or  iced  water  for  a  few  minutes,  and  then 
covering  it  with  warm  flannel,  and  this  frequently  repeated, 
might,  by  accumulation  of  fenforial  power,  contribute  to  reftore 
it  to  a  ftate  of  voluntary  excitability.  As  this  accumulation  of 
fenforial  power,  and  confequent  glow,  feem,  in  the  prefent  cafe, 
feveral  times  to  have  contributed  to  reftore  the  numbnefs  or  ina- 
bility of  thofe  mufcles,  which  at  length  became  paralytic.  Sec 
Clafsl.  2.  3.  21. 

M.  M.  Ether  externally.  Friction.  Saline  warm  batl 
Electricity.  Mercurial  ointment.  See  Clafs  I.  2.  4.  8. 

5 .  Raucedo  paralytica.     Paralytic  hoarfenefs  confifts  in  the 
moil  total  lofs  of  voice,  which  fometimes  continues  for  mont 
or  even  years,  and  is  occafioned  by  inability  or  paralyfis  of  tl 
recurrent  nerves  which  ferve  the  mufcles  of  vocality,  by  oj 
in;?  or  clofing  the  larynx.    The  voice  generally  returns  fuddenly, 
even  fo  as  to  alarm  the  patient.     A  young  lady,  who  had  man] 
months  been  affected  with  almoft  a  total  lofs  of  voice,  and  h; 
in  vain  tried  variety  of  advice,  recovered  her  voice  in  an  inftant 
on  fome  alarm  as  me  was  dancing  at  an  aflembly.     Was  this 
owing  to  a  greater  exertion  of  volition  than  ufual  ?    like 
dumb  young  man,  the  fon  of  Crcefus,  who  is  related  to  ha> 
cried  out,  when  he  faw  his  father's  life  endangered  by  the  fwoi 
of  his  enemy,  and  to  have  continued  to  fpeak  ever  afterwarc 
Two  young  ladies  in  this  complaint  feerned  to  be  cured  by  elec 
trie  (hocks  patted  through  the  larynx  every  day  for  a  fortnight 
See  Raucedo  catarrhalis,  Clafs  II.  i.  3.  5. 

M.  M.  An  emetic.  Electric  (hocks.  Mu (lard-feed,  a  lar£ 
fpoonful  fwallowed  whole,  or  a  little  bruifed,  every  morninj 
Valerian.  Burnt  fponge.  Blifters  on  each  fide  of  the  Jaryn: 
Sea-bathing.  A  gargle  of  decoction  of  feneca.  Friction.  Fi 
quent  endeavours  to  Ihout  and  (ing. 

6.  Veftca  urinaritc  paralyfis.     Paralyfis  of  the  bladder  is  fr 
quently  a  fymptom  in  irritative  fever  ;  in  this  cafe  the  patiei 
makes  no  water  for  a  day  or  two  ;  and  the  tumor  of  the  bla( 
der  diilended  with  urine  may  be  feen  by  the  (hape  of  the  abd< 
men,  as  if  girt  by  a  cord  below  the  navel,  or  diftinguifhed 
the  hand.     Many  patients  in  this  fituation  make  no  complaint 
and  fuffer  great  injury  by  the  inattention  of  their  attendants 
the  water  rnufb  be  drawn  off  once  or  twice  a  day  by  means  of 
catheter,  and  the  region  of  the  bladder  gently  prefled  by  tl 
hand,  whilft  the  patient  is  keot  in  a  fitting  or  erect  pofture.    S( 
Clafs  II.  2.  2.  6. 

M.  M.  Bark.  Wine.  Opium,  a  quarter  of  a  grain  evei 
fix  hours.  Balfam  of  copaiva  or  of  Peru.  Tincture  of  cai 
tharidss  20  drops  twice  a  day,  or  repeated  fmall  blifters. 

An 


CLASS  III.  2.1.7-        OF  VOLITION.  3  3  5 

An  inability  to  empty  the  bladder  frequently  occurs  to  elder- 
ly men,  and  is  often  fatal.  This  fometiines  arifes  from  their 
having  too  long  been  reftrained  from  making  water  from  acci- 
dental confinement  in  public  fociety,  or  otherwife  j  whence  the 
bladder  has  become  fo  far  diftended  as  to  become  paralytic  ;  and 
not  only  this,  but  the  neck  of  the  bladder"  has  become  contracted 
fo  as  to  refift  the  introduction  of  the  catheter.  In  this  deplora- 
ble cafe  it  has  frequently  happened,  that  the  forcible  efforts  to 
introduce  the  catheter  have  perforated  the  urethra  ;  and  the  in- 
ftrument  has  been  fuppofed  to  pafs  into  the  bladder,  when  it  has 
only  pafled  into  the  cellular  membrane  along  the  fide  of  it  j  of 
which  I  believe  I  have  feen  two  or  three  inftances  5  and  after- 
wards the  part  has  become  fo  much  inflamed  as  to  render  the 
introduction  of  the  catheter  into  the  bladder  impracticable. 

In  this  fituation  the  patients  are  in  imminent  danger,  and 
fome  have  advifed  a  trocar  to  be  introduced  into  the  bladder 
from  the  rectum ;  which  I  believe  is  generally  followed  by  an 
incurable  ulcer.  One  patient,  whom  I  faw  in  this  fituation,  be- 
gan to  make  a  fpoonful  of  water  after  fix  or  feven  days,  aad  grad- 
ually in  a  few  days  emptied  his  bladder  to  about  half  its  fize, 
and  recovered  ;  but  I  believe  he  never  afterwards  was  able  com- 
pletely to  evacuate  it. 

In  this  fituation  I  lately  advifed  about  two  pounds  of  crude 
quickfilver  to  be  poured  down  a  glafs  tube,  which  was  part  of  a 
barometer  tube,  drawn  lefs  at  one  end,  and  about  two  feet  long, 
into  the  urethra,  as  the  patient  lay  on  his  back  ;  which  I  had 
previouily  performed  upon  a  horfe ;  this  eafily  pafled,  as  was 
fuppofed,  into  the  bladder  ;  on  Handing  erect  it  did  not  return, 
but  on  kneeling  down,  and  lying  horizontally  on  his  hands,  the 
mercury  readily  returned  ;  and  on  this  account  it  was  be!: 
to  have  pafled  into  the  bladder,  as  it  fo  eafily  returned,  when  the 
neck  of  the  bladder  was  lower  than  the  fund  us  of  it.  But  nev- 
erthelefs  as  no  urine  followed  the  mercury,  though  the  bladder 
was  violently  diftended,  I  was  led  to  believe,  that  the  urethra 
had  been  perforated  by  the  previous  efforts  to  introduce  a  cathe- 
ter and  bougie  ;  and  that  the  mercury  had  pafled  on  the  outfide 
of  the  bladder  into  the  cellular  membrane. 

As  the  urethra  is  fo  liable  to  be  perforated  by  the  forcible  ef- 
forts to  introduce  the  catheter,  when  the  bladder  is  violently  dif- 
tended in  this  deplorable  difeafe,  I  thould  ftron^ly  recommend 
the  injection  of  a  pound  or  two  of  crude  mer  the  ure- 

thra to  open  by  its  weight  the  neck  of  the  bladder  previous  to 
any  violent  or  very  frequent  eflays  with  a  catheter  whether  of 
metal  or  of  elaftic  refin. 

7-  ReiTiiparaltfis.  .   Palfy  of  the  rectum.     The  rectum  intef- 

tinum, 


DISEASES  CLASS  III.  a, 


tinum,  like  the  urinary  bladder  in  the  preceding  article,  poflefles 
voluntary  power  of  motion  ;  though  thefe  volitions  are  at  times 
uncontrolable  by  the  will,  when  the  acrimony  of  the  contained 
feces,  or  their  bulk,  ftimulates  it  to  a  greater  degree.  Hence  it 
happens,  that  this  part  is  liable  to  lofe  its  voluntary  power  by 
paralyfis,  but  is  (till  liable  to  be  flimulated  into  action  by  the 
contained  feces.  This  frequently  occurs  in  fevers,  and  is  a  bad 
fign  as  a  fymptom  of  general  debility ;  and  it  is  the  fenfibility  of 
the  mufcular  fibres  of  this  and  of  the  urinary  bladder  remaining, 
after  the  volantarity  has  ceafed,  which  occasions  thefe  two  ref- 
ervoirs  fo  foon  to  regain,  as  the  fever  ceafes,  their  obedience  to 
volition  ;  becaufe  the  paralyfis  is  thus  {hewn  to  be  lefs  complete 
in  thofe  cafes  than  in  common  hemiplegia  ;  as  in  the  latter  the 
fenfe  of  touch,  though  perhaps  riot  the  fenfe  of  pain,  is  generally 
deftroyed  in  the  paralytic  limb. 

M.  M.  A  fponge  introduced  within  the  fphincter  ani  to  pre- 
vent the  conftant  difcharge,  which  fhould  have  a  firing  put 
through  it,  by  which  it  may  be  retracted. 

8.  Pare/is  volunlaria.     Indolence  ;  or  inaptitude  to  voluntary 
aftion.     This  debility  of  the  exertion  of  voluntary  efforts  pre- 
vents the  accompli fhment   of  all  great  events  in  life.     It  often 
originates  from  a  miftaken  education,  in  which  pleafure  or  flat* 
tery  is  made  the  immediate  motive  of  action,  and  not  futue  ad- 
vantage ;  or  what  is  termed  duty.     This  obfervation  is  of  great 
value  to  thole,  who  attend  to  the  education  of   their  own  chil- 
dren.    I  have  feen  one  or  two  young  married  ladies  of  fortune, 
who  perpetually  became  uneafy,  and  believed  themfelves  ill,    a 
week  after  their  arrival  in  the  country,  and  continued  fo  uniform- 
ly during  their  ftay  •,  yet  on  their  return  to  London  or  Bath  im- 
mediately loft  all  their  complaints,  and  this  repeatedly  ;  which  I 
was  led  to  afcribe  to  their  being  in  their  infancy  furrounded  with 
menial  attendants,  who  had  flattered  them  into  the  exertions 
they  then  ufed.     And  that  in  their  riper  years,  they  became  tor- 
pid for  want  of  this  ilimuius,  and  could  not  amufe  themfelves 
by  any  -voluntary  employment ;  but  required  ever  after,  either 
to  be  amufed  by  other  people,  or  to  be  flattered  into  activity. 
This  I  fuppofe,  in  the  other  fex,  to  have  fupplied  one  fource  of 
ennui  and  fuicide.     See  Clafs  III.    i.   2.    11. 

9.  Catalepfts  is  fometimes  uftd  for  fixed  fpafmodic  contractions 
or  tetanus,  as   defcribed  in  Sect.  XXXIV.    i.    ^.  and   in  Clafs 
III.    i.  i.  13.  but  is  properly  fimply  an  inaptitude  to  mufcular 
motion,  the  limbs  remaining  in  any  attitude  in  which  they  are 
placed.     One  patient  whom  I  faw  in    this  fituation,   had  taken 
much  mercury,   and  appeared  univerfally  torpid.     He  fat  in  a 
chair  in  any  pofture  he  was  put,  and  held   a  glafs  to  his  mouth 

for 


„ 

%fl%c, 


CLASS  III.  2.  i.  10.       OF  VOLITION. 

'.any  minutes  without  attempting  to  drink,  or  withdraw 
his  hand.     He  never  fpoke,   and  it  was   at   firft    neceiTary   to 
compel  him  to  drink  broth  j   he  recovered  in  a  few  weeks  with- 
out relapfe. 

10.  Hemiplegia.  Palfy  of  one  fide  con  fids  in  the  total  difo- 
bedience  of  the  affected  mufcles  to  the  power  of  volition.  A& 
the  voluntary  motions  are  not  perpetually  exerted,  there  is  little 
ienforial  power  accumulated  during  their  quiefcence,  whence 
they  are  lefs  liable  to  recover  from  torpor,  and  are  thus  more 
frequently  left  paralytic,  or  difobedient  to  the  power  of  volition, 
though  they  are  fometimes  (till  alive  to  painful  fenfation,  as  to 
the  prick  of  a  pin,  and  to  heat ;  alfo  to  irritation,  as  in  ftretch- 
ing  and  yawning ;  or  to  electric  ihocks.  Where  the  paralyfis 
is  complete  the  patient  feems  gradually  to  learn  to  ufc  his  limbs 
over  again  by  repeated  efforts,  as  in  infancy  ;  and,  as  time  is  re- 
quired for  this  purpofe,  it  becomes  difficult  to  know,  whether 
the  cure  is  owing  to  the  effect  of  medicines,  or  to  the  repeated 
efforts  of  the  voluntary  power. 

The  diipute,  whether  the  nerves  decuflate  or  crofs  each  other 
before  they  leave  the  cavities  of  the  fkull  or  fpine,  feems  to  be 
decided  in  the  affirmative  by  comparative  anatomy ;  as  the  op- 
erves  of  fome  fiih  have  been  fhewn  evidently  to  crofs  each 
other ;  as  feen  by  Haller,  Elem.  Phyfiol.  t.  v.  p.  349.  Hence 
the  application  of  blifters.or  of  ether,  or  of  warm  fomentations, 
{hould  be  on  the  fide  of  the  head  oppofite  to  that  of  the  arTe£ted 
mufcles.  This  fubjett  mould  neverthelefs  be  nicely  determin- 
ed, before  any  one  mould  trepan  for  the  hydrocephalus  inter- 
nus,  when  the  difeafe  is  (hewn  to  exift  only  on  one  fide  of  the 
brain,  by  a  fquinting  affecting  but  one  eye  i  as  propofed  in. 
I.  2.  5.  4.  Dr.  Sommering  has  (hewn,  that  a  true  decuf- 
iation  of  the  optic  nerves  in  the- human  fubject  actually  exiits, 
Eiem.  of  Phyliology  by  Blumenbach,  tranflated  by  C.  Caldwell, 
Philadelphia.  This  further  appears  probable  from  the  oblique 
direction  and  infertion  of  each  optic  nerve,  into  the  fide  of  the 
eye  next  to  the  nofe,  in  a  direct  line  from  the  oppofite  fide  of 
the  brain. 

The  vomiting,  which  generally  attends  the  attack  of  hemiple- 
gia,  is  mentioned  in  Sect.  XX.  8.  and  is  fimilar  to  that  attend- 
ing vertigo  in  fea-ficknefs,  and  at  the  commencement  of  fome 
fevers.  Black  itools  loJte times  attend  the  commencement  of 
hemiplegb,  which  is  probably  an  effufion  of  blood  from  the 
biliary  duct,  wher,  -  is  previoufly  afiv£ted  ;  or  foaie  blood 

may  be  derived  to  rhe  intefrines  by  its  efcaping  from  the  vena 
cava  into  the  receptacle  of  chyle  during  the  diltrefs  of  the  para- 
lytic  attack  ;  and  may  be  conveyed  from  thence  into  the  intrf- 
VOL.  II.  U  u 


333  DISEASES          CLASS  III.  2.  i.  10. 

tines  by  the  retrograde  motions  of  the  lacteals  ;  as  probably 
fometimes  happens  in  diabetes.  iSee  Sett.  XXVII.  2.  Palfyof 
one  fide  of  the  face  is  mentioned  in  Clafs  II.  i.  4.  6.  Paralyfis 
of  the  lacteals,  of  the  liver,  and  of  the  veins,  which  are  defcrib- 
ed  in  Seel.  XXVIII.  XXX.  and  XXVII.  do  not  belong  to  this 
clafs,  as  they  are  not  difeafes  of  voluntary  motions. 

M.  M.  The  electric  fparks  and  fhccks,  if  ufed  early  in  the 
difeafe,  are  frequently  of  fervice.  A  purge  of  aloes,  or  calo- 
mel. A  vomit.  Blifter.  Saline  draughts.  Then  the  bark. 
Mercurial  ointment  or  fublimate,  where  the  liver  is  evidently 
fed  ;  or  where  the  guttarofea  has  previoufly  exiited.  Sud- 
ilen  alarm.  Frequent  voluntary  efforts.  Externally  ether. 
Volatile  alkali.  Fomentation  on  the  head.  Friction.  When 
children,  who  have  fullered  a  hemipiegia,  begin  to  ufe  the  af- 
fected arm,  the  other  hand  ihould  be  tied  up  for  half  an  hour 
three  or  four  times  a  day;  which  obliges  them  at  their  play  to 
nib  more  frequent  voluntary  efforts  with  the  difeafed  limb,  and 
boner  to  rcitore  the  difievered  affociations  of  motion. 

In  hemiple^ia,  as  well  as  toward  the  end  of  fome  fevers  with 
great  debility,  the  parts  about  the  loins  are  liable  to  mortify  by 
the  preiTure  of  a  continued  recumbency  upon  them,  and  in  part 
by  the  fridion  of  thofe  parts  againft  the  meet,  as  the  patient 
dides  down  again  after  being  frequently  raifed  higher  in  his  bed, 
to  prevent  which  a  pillow  fhould  be  put  beneath  the  under- 
Iheet  half  way  down  the  bed,  as  in  Clafs  II.  i.  2.  4.  A  folu- 
tion  of  fugar  of  lead,  or  white  lead  in  fine  powder,  or  a  cerate 
of  lapis  ealaminaris  contributes  to  heal  or  to  prevent  thefe  ex- 
coriations. But  the  mott  efficacious  preventive  confifts  in  the 
patient's  wearing  a  pair  of  linen  drawers  ;  by  which  means, 
when  he  Ilides  down  in  his  bed,  the  friction  will  be  between  the 
t  and  his  drawer.;,  not  between  the  (heet  and  his  (kin  ;  and 
this  greater  friction  will  in  general  prevent  his  fliding  down  in 
bed,  when  his  head  and  ihoulders  are  raifed  on  more  pillows, 
which  will  on  this  account  alib  contribute  much  to  his  comfort; 
this  is  alib  worthy  the  attention  of  thofe  dropfical  patients,  who 
are  neceilitated  to  lie  with  the  head  raifed  high  in  bed. 

When  thefe  patients  have  any  difficulty  of  fwallowing,  they 
(hould  be  raifed  up  when  any  fluid  is  put  into  the  mouth,  left  it 
ihould  iufiocate  them.  See  Apoplexia,  No.  16.  Nor  mould 
young  children  be  fed  as  they  lie  on  their  backs,  as  they  are 
then  obliged  to  fwallow  as  much  as  the  nurfe  pleafes;  like  one 
of  the  punifhrnents  formerly  ufed  in  the  inquifition,  where  the 
delinquent  was  made  to  fwallow  many  quarts  of  water,  as  he 
•was  chained  down  on  his  back,  and  was  fuffocated  by  it. 

In  paralyfis  of  the  wrifts  from  lead,  Mr.  Clutterbuck  has  late- 


CLASS  III.  2.  i.  1 1.      OF  VOLITION.  339 

ly  publifhed  fome  fucccfsful  cafes  of  the  ufe  of  mercurial  oint- 
ment. See  Colica  Saturnina,  I.  2.  4.  8.  See  Clafe  III.  2.  i.  4. 
Dr.  J.  Alderfon  has  lately  much  recommended  the  leaves  of 
rhus  toxicodendron  (fumach),  from  i.  gr.  to  iv.  of  the  dried 
powder  to  be  taken  three  or  four  times  a  day.  Eflay  on  Rhus 
Toxic.  Johnfon,  Londctfi,  1793.  But  it  is  difficult  to  know 
what  medicine  is  of  fcrvice,  as  the  movements  of  the  mufcles 
mult  again  be  learned,  as  in  infancy,  by  frequent  efforts. 

11.  Paraplegia.     A  palfy  of  the  lower  half  of  the  body  di- 
vided horizontally.     Animals  may  be  conceived  to  have  double 
bodies,  one  half  in  general  refembling  fo  exactly  the  other,  and 
being  fupplied  with  feparate  fets  of  nerves  •,  this  gives  rife  to 
hemiplegia,  or  palfy  of  one  half  of  the  body  divided  vertically  ; 
but  the  paraplegia,  or  palfy  of  the  lower  parts  of  the  fyftem, 
depends  on  an  injury  of  the  fpinal  marrow,  or  that  part  of  the 
bruin  which  is  contained  in  the  vertebrae  of  the  back  ;  by  which 
ail  the  nerves  fituated  below  the  injured  part  are  deprived  of 
their  nutriment,  or  precluded  from  doing  their  proper  offices  ; 
and  the  mufcles,  to  which  they  are  derived,  are  in  confequence 
difobediem  to  the  power  of  volition. 

This  fometimes  occurs  from  an  external  injury,  as  a  fall  from 
an  eminence  ;  of  which  I  faw  a  deplorable  initance,  where  the 
bladder  and  recium,  as  well  as  the  lower  limbs,  were  deprived 
of  fo  much  of  their  powers  of  motion,  as  depended  on  volition 
or  fenfation  ;  but  I  fuppofe  not  of  that  part  of  it,  which  dep. 
on  irritation.  In  the  fame  manner  as  the  voluntary  mufcles  in 
hemiplegia  are  fometimes  brought  into  action  by  irritation,  as 
in  ftretching  or  pandiculation,  deicribed  in  Sect.  VII,  i.  3. 

But  the  moil  frequent  caufe  of  paraplegia  is  from  a  protuber- 
of  one  of  the  fpinal  vertebrae  ;  which  is  owing  to  the  in- 
nutrition or  foftnefs  of  bones,  defcribed  in  Clafs  I.  2.  2.  17. 
The  cure  of  this  deplorable  diieafe  is  frequently  efffcfed  by  the 
ilimulus  of  an  iffue  placed  on  each  fide  of  the  prominent  foine, 
as  ririb  pubiilhed  by  Mr.  Pott.  The  other  means  recommend- 
ed in  foftnefs  of  bones  ihould  alto  be  attended  to  ;  both  in  re- 
fpect  to  the  internal  medicines,  and  to  rhe  mechanical  methods 
of  fuppcrting,  or  extending  the  fpine  •,  which  laft,  however,  in 
this  cafe  requires  particular  caution. 

12.  Somnus.     In  deep  all  voluntary  power  is  fufpencted, 
Sec.1.  XVIII.     An  unufual  quantity  of  ilcep  is  often  produc- 

>y  weaknefs.     In   this  cafe   imall   dofes   of  opium,   -. 
and  bark,   may  be  given  with  advantage.     Fur  the  periods  of 

,  fee  Clafs  IV.  2.  4.  i. 
The  fublequent  ingenious  obfcrvations  on  .•  of 


340  DISEASES  CLASS  III.  2.  i.  11. 

the  pulfe,  which  fometimes  occurs  in  ileep,  are  copied   from  a 
letter  of  Dr.  Currie  of  Liverpool  to  the  author. 

"  Though  reft  in  general  perhaps  renders  the  healthy  pulfe 
flower,  yet  under  certain  circumitances  the  contrary  is  the  truth. 
A  full  meal  without  wine  or  other  ftrong  liquor  does  not  in- 
creafe  the  frequency  of  my  pulfe,  while  I  fit  upright,  and  have 
my  attention  engaged.  But  if  1  take  a  recumbent  pofture  af- 
ter eating,  my  pulfe  becomes  more  frequent,  efpecially  if  my 
mind  be  vacant,  and  I  become  drowfy  ;  and,  if  I  flumber, 
this  increafed  frequency  is  more  confiderable  with  heat  and 
fiufhing. 

"  This  I  apprehend  to  be  a  general  truth.  The  obfervation 
may  be  frequently  made  upon  children  ;  and  the  reftlefs  and  fe- 
verifh  nights  experienced  by  many  people  after  a  full  fupper  are, 
I  believe,  owing  to  this  caufe.  The  fupper  occafions  no  incon- 
venience, whilft  the  perfon  is  upright  and  awake  ;  but,  when 
he  lies  down  and  begins  to  fleep,  efpecially  if  he  does  not  per- 
fpire,  the  fymptoms  above  mentioned  occur.  Which  may  be 
thus  explained  in  part  from  your  principles.  When  the  power 
of  volition  is  abblifhed,  the  other  fenforial  actions  are  increafed. 
In  ordinary  fleep  this  does  not  occafion  increafed  frequency  of 
the  pulfe  ;  but  where  fleep  takes  place  during  the  procefs  of  di- 
geftion, the  digeftion  itfelf  goes  on  with  increafed  rapidity. 
Heat  is  excited  in  the  fyftem  falter  than  it  is  expended  ;  and 
operating  on  the  fenfitive  actions,  it  carries  them  beyond  the 
limitation  of  pleafure,  producing,  as  is  common  in  fuch  cafes, 
increafed  frequency  of  pulfe. 

"  It  is  to  be  obferved,  that  in.  fpeaking  of  the  heat  generated 
under  thefe  circum (lances,  I  do  not  allude  to  any  chemical  evo- 
lution of  keat  from  the  food  in  the  procefs  of  digeftion.  I  doubt 
if  this  takes  place  to  any  confiderable  degree,  for  I  do  not  ob- 
ferve  that  the  parts  incumbent  on  the  ftomach  are  increafed  in 
heat  during  the  moft  hurried  digeftion.  It  is  on  fome  parts  of 
the  furface,  but  more  particularly  on  the  extremities  of  the  body, 
that  the  increafed  heat  excited  by  digeftion  appears,  and  the 
heat  thus  produced  arifes,  as  it  mould  feem,  from  the  fympa- 
thy  between  the  ftomach  and  the  veflels  of  the  ikin.  The  parts 
moft  affected  are  the  palms  of  the  hands,  and  the  foles  of  the 
feet.  Even  there  the  thermometer  feldom  rifes  above  97  or  98 
degrees,  a  temperature  not  higher  than  that  oi  the  trunk  of  the 
body  ;  but  three  or  four  degrees  higher  than  the  common  tem- 
perature of  thefe  parts,  and  therefore  producing  an  uneaiy  fen- 
fatibn  of  heat,  a  fenfation  increafed  by  the  great  fen fibility  of  the 
parts  affected. 

c;  That  the  increafed  heat  excited  by  digeftion  in  flccp  is   the 

caufe 


GLASS  III.  2.  i.  12.        OF  VOLITION.  341 

caufe  of  the  accompanying  fever,  fecms  to  be  confirmed  by  ob- 
frrvin^,  that  if  an  increafed  expenditure  of  heat  accompanies 
ncreafed  generation  of  it  (as  when  perfpiration  on  the  ex- 
tremities or  furface  attends  this  kind  of  fleep)  the  frequent  pulfe 
and  flufhed  countenance  do  not  occur,  as  I  know  by  experi- 
ment. If,  during  the  feverifh  fleep  already  mentioned,  I  am 
awakened,  and  my  attention  engaged  powerfully,  my  pulfe 
becomes  almoft  immediately  flower,  and  the  fever  gradually  fub- 
fides." 

From  thefe  obfervations  of  Dr.  Currie  it  appears,  that,  while 
in  common  fleep  the  actions  of  the  heart,  arteries,  and  capillaries, 
are  ftrengthened  by  the  accumulation  of  fenforial  power  during 
the  fufpenfion  of  voluntary  action,  and  the  pulfe  in  confequence 
becomes  fuller  and  flower  •,  in  the  feverifh  fleep  above  defcrib- 
ed  the  aclions  of  the  heart,  arteries,  and  capillaries,  are  quicken- 
ed as  well  as  ftrengthened  by  their  confent  with  the  increafed 
actions  of  the  ftomach,  as  well  as  by  the  ftimulus  of  the  new 
chyle  introduced  into  the  circulation.  For  the  ftomach,  and  all 
other  parts  of  the  fyftem,  being  more  fenfible  and  more  irritable 
during  fleep,  Seel:.  XVIII.  15.  and  probably  more  ready  to  aft 
from  aflbciation,  are  now  exerted  with  greater  velocity  as  well 
as  ftrength,  conftituting  a  temporary  fever  of  the  fenfitive  irri- 
tated kind,  refembling  the  fever  excited  by  wine  in  the  begin- 
ning of  intoxication ;  or  in  fome  people  by  a  full  meal  in  their 
waking  hours.  Sect.  XXXV.  i. 

On  waking,  this  increafed  fenfibility  and  irritability  of  the 
fyftem  ceafes  by  the  renewed  exertions  of  volition  ;  in  the  fame 
manner  as  more  violent  exertions  of  volition  deftroy  greater 
pains  ;  and  the  pulfe  in  confequence  fubfides  along  with  the  in- 
creafe  of  heat ;  if  more  violent  efforts  of  volition  are  exerted, 
the  fyftem  becomes  ftill  lefs  affected  by  fenfation  or  irritation* 
Hence  the  fever  and  vertigo  of  intoxication  are  leflened  by  in- 
tenfe  thinking,  Seel.  XXI.  8  ;  and  in  fane  people  are  known  to 
bear  the  pain  of  cold  and  hunger  better  than  others,  Seel:, 
XXXIV.  2.  ^  ;  and  laftly,  if  greater  voluntary  efforts  exift,  as 
in  violent  anger  or  violent  exercife,  the  whole  fyftem  is  thrown 
into  more  energetic  action,  and  a  voluntary  fever  is  induced,  as 
appears  by  the  red  (kin,  quickened  pulfe,  and  increafe  of  heat  ; 
whence  dropfies  and  fevers  with  debility  are  not  unfrequently 
removed  by  infanity. 

Hence  the  exertion  of  the  voluntary  power  in  its  natural  de- 
gree diminifhes  the  increafed    fenfibility,  and   irritability,   and 
probably  the   increafed  aflbciability,  which  occur  during  fleep  ; 
and  thus  reduces  the  frequency  of  the  pulfe  in  the  feveiiih  fleep 
r  a  nil)  meal.     In  its  more  powerful  date  of  exertion,  it  di- 

miniihes 


342  DISEASES  CLASS  III.  2.  i.  13. 

minimes  or  deftroys  fenfations  and  irritations,  which  are  ftronger 
than  natural,  as  in  intoxication,  or  which  precede  convulfions, 
or  infanity.  In  its  dill  more  powerful  degree,  the  fuperabun- 
dance  of  this  fenforial  power  actuates  and  invigorates  the  whole 
moving  fyftem,  giving  ftrength  and  frequency  to  the  pulfe,  and 
an  univerfal  glow  both  of  colour  and  of  heat,  as  in  violent  an- 
ger, or  outrageous  infanities. 

If,  in  the  feverim  fleep  above  defcribed,  the  (kin  becomes  cool- 
ed by  the  evaporation  of  much  perfpirable  matter,  or  by  the  ap- 
plication of  cooler  air,  or  thinner  clothes,  the  actions  of  the  cu- 
taneous capillaries  are  lefiened  by  defect  of  the  ftimulus  of  heat, 
which  counteracts  the  increafe  of  lenfibility  during  fleep,  and 
the  pulfations  of  the  heart  and  arteries  become  flower  from  the 
leflened  ftimulus  of  the  particles  of  blood  thus  cooled  in  the  cu- 
taneous and  pulmonary  vefTels.  Hence  the  admiflion  of  cold 
air,  or  ablution  with  fubtepid  or  with  cold  water,  in  fevers  with 
hot  (kin,  whether  they  be  attended  with  arterial  ftrength,  or  ar- 
terial debility,  renders  the  pulfe  flower  ;  in  the  former  cafe  by 
diminifhing  the  ftimulus  of  the  blood,  and  in  the  latter  by  lef- 
fening  the  expenditure  of  fenforial  power.  See  Suppl.  I.  8. 
and  15. 

13.  Incubus.  The  night-mare  is  an  imperfect  fleep,  where 
the  defire  of  locomotion  is  vehement,  but  the  mufcles  do  not 
obey  the  will ;  it  is  attended  with  great  uneafinefs,  a  fenfe  of 
fufFocation,  and  frequently  with  fear.  It  is  caufed  by  violent 
fatigue,  or  drunkenncfs,  or  indigeftible  food,  or  lying  on  the 
back,  or  perjiaps  from  many  other  kinds  of  uneafinefs  in  our 
fleep,  which  may  originate  either  from  the  body  or  mind. 

Now  as  the  action  of  refpiration  is  partly  voluntary,  this  com- 
plaint may  be  owing  to  the  irritability  of  the  fyftem  being .  too 
fmall  to  carry  on  the  circulation  of  the  blood  through  the  lungs 
during  fleep,  when  the  voluntary  power  is  fufpended.  Whence 
the  blood  may  accumulate  in  them,  and  a  painful  oppreflion  fu- 
pervene  ;  as  in  fome  haemorrhages  of  the  lungs,  which  occur 
during  fleep  ;  and  in  patients  much  debilitated  by  fevers.  See 
Somnus  interruptus,  Clafs  I.  2.  i.  3.  and  I.  2.  i.  9. 

Great  fatigue  with  a  full  fupper  and  much  wine,  I  have  been 
well  informed  by  one  patient,  always  produced  this  difeafe  in 
hinnelf  to  a  great  degree.  Now  the  general  irritability  of  the 
fyftem  is  much  decreafed  by  fatigue,  as  it  exhaufts  the  fenforial 
power  ;  and  fecondly,  too  much  wine  and  ftimulating  food  will 
again  diminiftv  the  irritability  of  fome  parts  of  the  fyftem,  by 
employing  a  part  of  the  fenforial  power,  which  is  already  too 
fmall,  in  digeiting  a  great  quantity  of  aliment  ^  and  in  increafing 
the  motions  of  the  organs  of  fenfe  in  confequeuce  of  foir< 


CLASS  III.  2.  1. 14-         OF  VOLITION.  343 

gree  of  intoxication,  whence  difficulty  of  breathing  may  occur 
irom  the  inirritability  of  the  lungs,  as  in  Clafs  I.  2.  i.  3. 

This  explains  an  apparent  paradox,  why  people  who  are  fee- 
ble, digeft  their  dinners  beft,  if  they  lie  down  and  fleep,  as  moft 
animals  do,  when  their  ftomachs  are  full.  Yet  many  weak  peo- 
ple fleep  very  uneafily  after  a  large  fupper.  If  the  debility  of 
the  patient  be  not  very  great,  and  the  dinner  he  has  taken,  be 
moderate,  the  fufpenfion  of  voluntary  a£Hon  during  fleep  pre- 
vents the  expenditure  of  fo  much  fenforial  power,  which  may 
be' employed  on  the  actions  of  the  ftomach,  and  thus  facilitate 
the  digeftive  procefs.  If  the  patient  be  further  exhaufted  as  in 
the  evening,  or  his  debility  greater,  and  fleep  enfues  after  a  co- 
pious or  itimulating  fupper,  fo  much  fenforial  power  will  be 
i'd  on  the  actions  of  the  ftomach  for  digeftion,  that  the 
circulation  of  the  blood  through  the  lungs  will  be  impeded  from 
the  diminifhed  irritability  to  external  ftimuli,  and  the  abfence 
of  volition,  as  in  the  incubus,  and  fomrms  interruptus. 

M.  M.  To  fleep  on  a  hard  bed  with  the  head  raifed.  Mod- 
erate fupper.  The  bark.  By  fleeping  on  a  harder  bed  the  pa- 
tient will  turn  himfelf  more  frequently,  and  not  be  liable  to 
fleep  too  profoundly,  or  lie  too  long  in  one  pofture.  To  be 
awakened  frequently  by  an  alarm  clock. 

14.  Lethargus.     The  lethargy  is   a   flighter  apoplexy.     It  is 
fuppoied  to  originate  from  univerfal  preffure  on  the  brain,  and 
is  laid  to  be  produced  by  comprefling  the  fpinal  marrow,  where 
there  is  a  deficiency  of  the  bone  in  the  fpina  bifida.     See  Seel. 
XVIII.  20.     Whereas  in  the  hydrocephalus  there  is  only  a  par- 
tial preffure  of  the  brain  ;  and  probably  in  nervous  fevers  with 
ituporthe  preffure  on  the  brain  may  affect  only  the  nerves  of  the 
fenfes,  which  lie  within   the   Ikull,  and  not  thofe  nerves  of  the 
medulla  oblongata,  which  principally  contribute   to  move  the 
heart  and  arteries  ;  whence  in  the  lethargic  or  apoplectic  ftu- 
por  the  pulfe   is  flow  as  in  fleep,  whereas  in  nervous  fever  the 
pulfe  is  very  quick  and  feeble,  and  generally  fo  in  hydrocephalus. 

In  cafes  of  obftrudted  kidneys,  whether  owing  to  the  tubuli 
uriniferi  being  totally  obftru&ed  by  calculous  matter,  or  by 
their  paralyfis,  a  kind  of  drowfinefs  or  lethargy  comes  on  about 
the  eighth  or  ninth  day,  and  the  patient  gradually  finks.  See 
Clafs  I.  i.  3.9. 

15.  Syncope  epileptica,  is  a  temporary  apoplexy,  the  pulfe  con- 
tinuing in  its  natural  ftate,  and  the  voluntary  power  fufpended. 
This  terminates  the  paroxyfms  of  epilepfy. 

When  the  animal  power  is  much  exhaufted  by  the  preced- 
ing convulfions,  fo  that  the  motions  from  fenfation  as  well  as 
thole  from  volition  are  fufpended  ;  in  a  quarter  or  half  an  hour 

the 


H44  DISEASES       .     CLASS  III.  a.  i.  16. 

the  fenforial  power  becomes  reftored,  and  if  no  pain,  or  irrita- 
tion producing  pain,  recurs,  the  fit  of  epilepfy  ceafes  ;  if 
the  pain  recurs,  or  the  irritation,  which  ufed  to  produce  it,  a  new- 
fit  of  convulfion  takes  place,  and  is  fucceeded  again  by  a  fyn- 
cope.  See  Epilepfy,  Clafs  III.  i.  i.  7. 

1 6.  Apoplexia.  Apoplexy  may  be  termed  an  univerfal  palfy, 
or  a  permanent  fleep.  In  which,  where  the  pulfe  is  weak,  co- 
pious bleeding  muft  be  injurious  ;  as  is  well  obferved  by  Dr. 
Heberden,  Tranf.  of  the  College. 

Mr. ,  about  70  years  of  age,  had  an  apoplectic  feizure. 

His  pulfe  was  ftrong  and  full.  One  of  the  temporal  arteries 
was  opened,  and  about  ten  ounces  of  blood  fuddenly  taken  from 
it.  He  feemed  to  receive  no  benefit  from  this  operation  j  but 
gradually  funk,  and  lived  but  a  day  or  two. 

If  apoplexy  arifes  from  the  preffure  of  blood  extravafated  on 
the  brain,  one  moderate  venefecTion  may  be  of  fervice  to  pre- 
vent the  further  effufion  of  blood  j  but  copious  venefeclion  muft 
be  injurious  by  weakening  the  patient-,  fince  the  effufed  blood 
mutt  have  time,  as  in  common  vibices  or  bruifes,  to  undergo  a 
chemico-animal  procefs,  fo  to  change  its  nature  as  to  fit  it  for 
abforption  ;  which  may  take  two  or  three  weeks,  which  time  a 
patient  weakened  by  repeated  venefeclion  or  arteriotomy  may 
not  furvive. 

Mrs. ,  about  40  years  old,  had  an  apoplectic  feizure  af- 
ter great  exertion  from  fear  ;  me  had  lain  about  24  hours  with- 
out Ipeech,  or  having  fwallowed  any  liquid.  She  was  then  forci- 
bly raifed  in  bed,  and  a  fpoonful  of  folution  of  aloes  in  wine  put 
into  her  mouth,  and  the  end  of  the  fpoon  withdrawn,  that  me 
might  more  eafily  fwallow  the  liquid. — This  was  done  every 
hour,  with  broth,  and  wine  and  water  intervening,  till  evacua- 
tions were  procured  ;  which  with  other  means  had  good  efFecl:, 
and  me  recovered,  except  that  a  confiderabie  degree  of  hemiple- 
gia  remained,  and  fome  imperfection  of  her  fpeech. 

Many  people,  who  have  taken  fo  much  vinous  fpirit  as  to  ac- 
' quire  the  temporary  apoplexy  of  intoxication,  and  are  not  im- 
properly faid  to  be  dead-drunk,  have  died  after  copious  venefec- 
tion,  I  fuppole  in  confequence  of  it.  I  once  faw  at  a  public 
meeting  two  gentlemen  in  the  drunken  apoplexy  ',  they  were  to- 
tally infenfible  with  low  pulfe,  on  this  account  they  were  directed 
not  to  lofe  blood,  but  to  be  laid" on  a  bed  with  their  heads  high, 
and  to  be  turned  every  half  hour  ;  as  foon  as  they  could  f wallow* 
warm  tea  was  given  them,  which  evacuated  their  (tomachs,  and 
they  gradually  recovered,  as  people  do  from  lefs  degrees  of  intox- 
ication. 

M.  M.     Cupping  on  the  occiput,  Yenefe&ion  once  in  mad* 


CLASS  III.  *.  1. 17.        OF  VOLITION.  345 

erate  quantity.  "Warm  fomentations  long  continued  and  fre- 
qutfhtly  repeated  on  the  fhaved  head.  Solution  of  aloes.  Clyf- 
ters  with  folution  of  aloes  and  oil  of  amber.  A  blifter  on  the 
fpine.  An  emetic.  Afterwards  the  bark,  and  fmall  dofes  of 
chalybeates.  Small  eleclric  (hocks  through  the  head.  Errhines. 
If  fmall  dofes  of  opium  ?  mercurial  ointment  rubbed  on  the 
head  or  neck  ? 

Where  there  is  a  difficulty  of  fwallowing  in  apoplectic  or  par- 
alytic patients,  or  in  thofe  near  death  in  fevers,  or  other  difeaf- 
es,  no  fluid  fhould  be  put  into  their  mouths  as  they  lie  upon 
their  backs,  left  it  mould  choke  them  ;  but  they  mould  be  raifed 
and  fupported  upright  in  their  beds,  and  ftimulated  by  ftrong 
light,  and  fpoken  to  in  a  louder  voice,  defiring  them  to  Iwallow, 
as  the  fluid  is  put  into  the  mouth,  and  the  fpoon  mould  be  im- 
mediately withdrawn,  that  they  may  clofe  their  mouths.  Hence 
if  they  cannot  fwallow,  it  will  flow  out  of  their  mouths,  and  not 
endanger  fufFocating  them.  See  Hemiplegia,  Spec.  10,  of  this 
genus. 

1 7.  Mors  a  frigore.  Death  from  cold.  The  unfortunate 
travellers,  who  almoft  every  winter  perifh  in  the  fnow,  are  much 
exhaufted  by  their  efforts  to  proceed  on  their  journey,  as 
well  as  benumbed  by  cold.  And  as  much  greater  exercife 
can  be  borne  without  fatigue  in  cold  weather  than  in  warm  ; 
becaufe  the  exceflive  motions  of  the  cutaneous  veflels  are  thus 
prevented,  and  the  confequent  wafte  of  fenforial  power  5  it  may 
be  inferred,  that  the  fatigued  traveller  becomes  paralytic  from 
violent  exertion  as  well  as  by  the  application  of  cold. 

Great  degrees  of  cold  afFecT:  the  motions  of  thofe  veflels  moft, 
which  have  been  generally  excited  into  *£lion  by  irritation  ;  for 
when  the  feet  are  much  benumbed  by  cold,  and  painful,  and  at 
the  fame  time  almoft  infenfible  to  the  touch  of  external  objects, 
the  voluntary  mufcles  retain  their  motions,  and  we  continue  to 
walk  on  ;  the  fame  happens  to  the  fingers  of  children  in  throw- 
ing fnow-balls,  the  voluntary  motions  of  the  mufcles  continue, 
though  thofe  of  the  cutaneous  veflels  are  benumbed  into  inac- 
tivity. 

Mr.  Thompfon,  an  elderly  gentleman  of  Shrewfbury,  was 
feized  with  hemiplegia  in  the  cold  bath  ;  which  I  fuppofe  might 
be  owing  to  fome  great  energy  of  exertion,  as  much  as  to  the 
coldnefs  of  the  water.  As  in  the  inftance  given  of  Mr.  Nairn, 
who,  by  the  exertion  to  fave  his  relation,  perifhed  himfelf.  See 
Seel.  XXXIV.  1.7. 

Whence  I  conclude,  that,  though  heat  is  a  fluid  ncceflary  to 
mufcular  motion,  both  perhaps  by  its  ftimulus,  and  by  its  keep- 
ing the  minute  component  parts  of  the  ultimate  fibrils  of  the 

VOL.  II.  W  w  mufclss 


34<>  DISEASES  CLASS!!!.  2. 1. 17. 

inufcles  or  organs  of  fenfe  at  a  proper  diftance  from  each  other  j 
yet  paralyfis,  properly  fo  called,  is  the  confequence  of  exhauf- 
tion  of  fenibrial  power  by  exertion.  And  that  the  accumula- 
tions of  it  during  the  torpor  of  the  cutaneous  veffels  by  expofure 
to  cold,  or  of  fome  internal  vifcus  in  the  cold  fits  of  agues,  are 
frequently  inftrumental  in  recovering  the  ufe  of  paralytic  limbs, 
or  of  the  motions  of  other  paralytic  parts  of  the  fyltem.  See 
Spec.  4.  of  this  genus. 

Animal  bodies  refift  the  power  of  cold  probably  by  their  ex- 
ertions in  confequence  of  the  pain  of  cold,  fee  Botan.  Gard.  V. 
i.  additional  note  xii.  But  if  thefe  increafed  exertions  be  too 
violent,  fo  as  to  exhauft  the  fenibrial  power  in  producing  un- 
neceffary  motions,  the  animal  will  probably  fooner  perim.  Thus 
a  moderate  quantity  of  wine  or  fpirit  repeated  at  proper  inter- 
vals of  time  might  be  of  fervice  to  thofe,  who  are  long  expofed 
to  excefiive  cold,  both  by  increafing  the  action  of  the  capillary 
veflels,  and  thus  producing  heat,  and  perhaps  by  increafing  in 
fbrrie  degree  the  fecretion  of  fenforial  power  in  the  brain.  But 
the  contrary  muft  happen  when  taken  immoderately,  and  not 
at  due  intervals.  A  well-'attefted  hiftory  was  once  related  to 
me  of  two  men,  who  fet  out  on  foot  to 'travel  in  the  fnow,  one 
of  whom  drank  two  or  three  glaffes  of  brandy  before  they  began  . 
their  journey,  the  other  contented  himfelf  with  his  ufual  diet 
and  potation  ;  the  former  of  whom  perifhed  in  fpite  of  any  af- 
fiftance  his  companion  could  afford  him  ;  and  the  other  perform- 
ed his  journey  with  iafety.  In  this  cafe  the  fenforial  power  was 
exhaufted  by  the  unneceffary  motions  of  incipient  intoxication 
by  the  ftimulus  of  the  brandy,  as  well  as  by  the  exertions  of 
walking  ;  which  fo  weakened  the  dram-drinker,  that  the  cold 
fooneY  deftroyed  him  ;  that  is,  he  had  not  power  to  produce  fuf- 
ficient  mufcular  or  arterial  action,  and  in  confequence  fufficient 
heat,  to  fupply  the  great  expenditure  of  it.  Hence  the  capilla- 
ries of  the  Ikin  firft  ceafed  to  act,  and  became  pale  and  empty ; 
next  thofe  which  are  immediately  afibciated  with  them,  as  the 
extremities  of  the  pulmonary  artery,  as  happens  on  going  into 
the  cold  bath.  By  the  continued  inaction  or  thefe  parts  of  the 
vafcular  fyftem  the  blood  becomes  accumulated  in  the  internal 
arteries,  and  the  brain  is  fuppofed  to  be  affected  by  its  compref- 
fion  ;  becaufe  thefe  patients  are  faid  to  fleep,  or  to  become  apo- 
plectic, before  they  die.  I  overtook  a  fifherman  afleep  on  his 
panniers  on  a  very  cold  froily  night,  but  on  waking  him  he  did 
not  appear  to  be  in  any  degree  of  ftupor.  See  Clafs  I.  2.  2.  i. 
When  travellers  are  benighted  in  deep  fnow,  they  might  fre- 
quently be  faved  by  covering  themfelves  in  it,  except  a  fmall 
aperture  for  air  ;  in  which  fituation  the  lives  of  hares,  (heep, 

and 


CLASS  III.  2.  1. 17.        OF  VOLITION.  347 

and  other  animals,  are  fo  often  preferved.  The  fnow,  both  in 
refpect  to  its  component  parts,  and  to  the  air  contained  in  its 
pores,  is  a  bad  conductor  of  heat,  and  will  therefore  well  keep 
out  the  external  cold ;  and  as  the  water,  when  part  of  it  dif- 
folves,  is  attracted  into  the  pores  of  the  remainder  of  it,  the  fit- 
uation  of  an  animal  beneath  it  is  perfectly  dry  •,  and,  if  he  is  in 
contact  with  the  earth,  he  is  in  a  degree  of  heat  between  48, 
the  medium  heat  of  the  earth,  and  32,  the  freezing  point  j  that 
is,  in  40  degrees  of  heat,  in  which  a  man  thus  covered  will  be 
as  warm  as  in  bed.  See  Botan.  Garden,  V.  II.  notes  on  Ane- 
mone, Barometz,  and  Mufcus.  If  thefe  facts  were  more  gen- 
erally underftood,  it  might  annually  fave  the  lives  of  many. 

After  any  part  of  the  vafcular  fyftem  of  the  body  has  been 
long  expofed  to  the  cold,  the  fenforial  power  is  fo  much  accu- 
mulated in  it,  that  on  coming  into  a  warm  room  the  pain  of  hot- 
acnTS  produced*  and  inflammation,  and  confequent  mortifica- 
tion, owing  to  the  great  exertion  of  thofe  veffels,  when  again  ex- 
pofed to  a  moderate  degree  of  warmth.  See  Sect.  XII.  5. 
Whence  *the  propriety  of  applying  bfit  very  low  degrees  of  heat 
'to  limbs  benumbee^flgk^old  at  firft,  as~"of  fnow  in  its  fiate  of 
diflblving,  which  is  atjWUfgrees  of  heat,  or  of  very  cold  water. 
A  French  writer  has  obferved,  that  if  frozen  apples  be  thawed 
gradually  by  covering  them  with  thawing  fnow,  or  immerfing 
them  in  very  cold  water,  they  do  notlofe  their  tafte  ;  if  this  fact 
was  well  afcertained,  it  might  teach  us  how  to  preferve  other 
ripe  fruits  in  ice-houfes  for  winter  confumption.  See  Suppl.  I. 

14-  3- 

The  pain  of-  cold  is  probably  owing  to  the  accumulation  of  the 
fenforial  power  of  irritation.  As  the  fkins  of  thofe,  who  have 
been  conftantly  ftimulated  into  great  action  by  external  heat, 
muft  foon  poflefs  an  accumulation  of  that  fenforial  power,  when 
the  ftimulus  of  heat  is  withdrawn.  See  tsedium  vita?  from  ac» 
cumulation  of  the  fenforial  power  of  volition.  III.  i.  2.  11. 


ORDO 


34*  DISEASES  CLASS  III.  2.  2.  i, 

ORDO  II. 

Decreased  Volition. 

GENUS  II. 

With  decreased  AElions  of  the  Organs  of  Senfe. 
SPECIES. 

i .  Recolleflionis  jaflura.  Lofs  of  recolle£tion.  This  is  the 
defeat  of  memory  in  old  people,  who  forget  the  actions  of  yef- 
terday,  being  incapable  of  voluntary  recollection,  and  yet  re- 
member thoie  of  their  youth,  which  by  frequent  repetition  are 
introduced  by  afTociation  or  fuggeftion.  This  is  properly  the 
paralyfis  of  the  mind  ;  the  organs  of  fenfe  do  not  obey  the  vol- 
untary power  ;  that  is,  our  ideas  cannot  be  recollected,  or  acted 
over  again  by  the  will. 

After  an  apoplectic  attack  the  patients,  on  beginning  to  re- 
cover, find  thernfelves  mod  at  a  lofs  in  recollecting  proper  names 
of  perfons  or  places ;  as  thofe  words  have  not  been  fo  frequent- 
ly aflbciated  with  the  ideas  they  ftand  for,  as  the  common  words 

of  a  language.     Mr. ,  a  man  of  ftrong  mind,  of  a  {hort- 

necked  family,  many  of  whom  had  fuffered  by  apoplexy,  after 
an  apoplectic  fit,  on  his  recovering  the  ufe  of  fpeech,  after  re- 
peated trials  to  remember  the  name  of  a  perfon  or  place,  applaud- 
ed himfelf,  when  he  fucceeded,  with  fuch  a  childifh  fmile  on  the 
partial  return  of  his  fagacity,  as  very  much  affected  me. — Not 
long,  alas !  to  return  j  for  another  attack  in  a  few  weeks  de- 
ilroyed  the  whole.  See  Clafs  IV.  2.  3.  8. 

I  :a\v  a  child  after  the  fmall-pox,  which  was  left  in  this  fitua- 
tk     i  it  was  lively,  active,  and  even  vigorous  j  but  mewed  that 
of  furprife,  which  novelty  excites,  at  every  object  it  view- 
ed 5  and  that  as  often  as  it  viewed  it.    I  never  heard  the  termin- 
ation of  the  cafe. 

2.  Stu-titia  vo/untaria.  Voluntary  folly.  The  abfence  of 
voluntary  power  and  confequent  incapacity  to  compare  the  ideas 
of  prefent  and  future  good.  Brute  animals  may  be  faid  to  be 
in  this  fituation,  as  they  are  in  general  excited  into  action  only 
by  their  prefent  painful  or  pleafurable  fenfations.  Hence  though 
they  are  liable  to  furprife,  when  their  pafling  trains  of  ideas  are 
diifevered  by  violent  ftimuli  •,  yet  are  they  not  affected  with 
wonder  or  allonifhment  at  the  novelty  of  objects ;  as  they  pof- 
fefs  but  in  a  very  inferior  degree,  that  voluntary  power  of  com- 
paring 


CLASS  III.  2.  2.  3.        OF  VOLITION.  349 

paring  the  prefent  ideas  with  thofe  previoufly  acquired,  which 
diftinguifhes  mankind  ;  and  is  termed  analogical  reafoning, 
when  deliberatively  exerted ;  and  intuitive  analogy,  when  ufed 
without  our  attention  to  it,  and  which  always  preferves  our 
hourly  trains  of  ideas  confiftent  with  truth  and  nature.  Sec 
Sea.  XVII.  3.  7. 

3.  Ratiocinatio  verbofa.  Verbal  reafoning.  This  arifes  from 
the  feeble  or  inaccurate  exertions  of  the  faculty  of  volition  in  the 
acl  of  recalling  the  ideas  of  things,  and  thus  miftaking  the  ideas 
of  words  for  them.  One  great  imperfection  of  language  con- 
fifts  in  the  ufe  of  what  Mr.  Home  Tooke  calls  general  terms,  as 
mentioned  in  Seel:.  XV.  i.  5.  and  Se6l.  XVI.  17.  of  this  work, 
arid  which  Mr.  Locke  fuppofed  to  exprefs  aBftracled  or  general 
ideas,  fuch  as  the  word  caftle  or  army,  which  in  common  con- 
verfation  includes  any  part  or  property  of  thofe  complex  things, 
and  is  thus  liable  to  miflead  inaccurate  thinkers.  Thus  it  was 
faid  laft  night,  "  That  horfe  ftrikes  fire  as  he  pafles  along  the 
pavement."  And  it  was  added  jocularly,  "  that  his  feet  muft' 
be  as  hard  as  iron,"  which  miftake  might  arife  from  the  general 
term,  horfe,  including  in  common  converfadon  both  every  part 
of  the  animal  and  his  accoutrements. 

A  fecond  fource  of  falfe  reafoning  may  arife  from  the  fame 
word  having  two  fignifications  totally  different  from  each  oth- 
er ;  which  may  miflead  thofe  who  reafon  from  ideas  of  words 
inftead  of  ideas  of  things.  Thefe  are  generally  efteemed  witti- 
cifms,  and  are  called  puns  or  quibbles ;  as  the  jocular  fyllogifm 
on  the  word  fpirit.  "  Brandy  is  a  fpirit  •,  the  Devil  is  a  fpirit ; 
therefore  brandy  is  the  devil." 

A  third  fource  of  falfe  reafoning  is  derived  from  the  two-fold 
meaning  of  fome  fentences,  or  phrafes  in  all  languages  ;  this  is 
alfo  ufed  designedly  in  jocular  compofitions,  and  constitutes  the 
wit  of  fome  comedies.  An  old  miller  riding  on  his  fack  of 
flour  was  accolted  by  two  young  Cantabs,  who  rode  on  each  fide 
of  him,  with  4<  Gentlemen  of  your  profeflion  have  ibmetimes  a 
doubtful  character — pray,  miller,  do  you  think  yourtelf  more 
knave  or  fool  ?"  the  witty  miller  anfxvered,  looking  firft  at  one 
of  them  and  then  at  the  other,  "  I  think  myfelf  at  prefent  be- 
tween both."  This  double  entendre  of  a  fentence  was  ufed  by 
the  priefts  of  the  ancient  oracles  to  deceive  the  inquirer  into  fu- 
ture events.  As  that  of 

Aio  te,  ^Eacide,  Romanes  vincere  pofic. 

I  %,  that  you,  -flSacides,  the  Romans  fhall  conquer. 

There  is  a  fourth  mode  of  verbofe  ratiocination,  which  cou- 
fifts  in  the  conclusion  of  the  fyllogifm  tontaining  an  imaginary, 

but 


350  DISEASES  CLASS  III.  2. 2. 4. 

but  not  even  a  verbal  analogy  to  the  preceding  propofitions. 
Thus  a  ruftic  devotee  faid  to  his  prieft,  "  I  have  often  wonder- 
ed, why  God  Almighty  called  the  firft  man  Adam  ?"  "  Don't 
you  know,"  replied  the  teacher,  "  that  A  is  the  firft  letter  of  the, 
alphabet  ?"  «  Aye,  ib  it  is,"  anfwered  the  contented  inquirer. 

Another  kind  of  falfe  reafoning  is  called  by  logicians  a  logic- 
al vice  ;  and  another  kind  arifes  from  the  firft  propoiition  being 
untrue  in  reipecl  to  its  exigence  :  buc  as  all  thefe,  and  perhaps 
many  other  fources  of  falfe  reafonings,  may  be  refolved  into  the 
miftaken  ufe  of  ideas  of  words,  or  general  terms,  inftead  of  ideas 
of  the  things,  or  parts  of  things,  which  they  ought  to  fuggeft  ; 
they  belong  properly  to  this  article  of  ratiocinatio  verbofa  : 
\vhile  the  rare  faculty  of  reafoning  without  words  by  comparing 
ideas  of  things,  as  in  the  invention  of  new  machines,  and  other 
new  discoveries,  diftinguifties  the  ph'Jofopher  from  the  fophift, 

M.  ;M.  Children  mould  be  permitted  to  ufe  their  hands  early 
in  their  infancy,  and  mould  be  fupplied  with  pencils,  pens,  and 
various  tools  ;  by  which  they  will  acquire  accurate  ideas  of  ex- 
ternal things  by  the  organ  of  touch,  at  the  fame  time  that  they 
acquire  woids  ;  and  will  thence  be  If  -o  be  feriouily  de- 

ceived by  general  terms,  or  by  the  double  meanings  of  words, 
>f  fentences,  or  laftly  by  falfe  propofitions  or  ineonclufive  de~ 
;  and  will  thus  be  enabled  to  compare  the  analogies  of 
things,  and  to  think  without  words  ;  the  faculty,  which  confti- 
tutes  genius,  and  which  fo  few  poiTefs  I 

4.  Credulitas,  Credulity.  Life  is  fhort,  opportunities  of 
knowledge  rare  j  our  fenfes  are  fallacious,  our  reafonings  un- 
certain,, man  therefore  ftruggles  with  perpetual  error  from  the 
cradle  to  the  coffin.  He  is  neceflitated  to  correct  experiment 
by  analogy,  and  analogy  by  experiment ;  and  not  always  to  reft 
fatisfied  in  the  belief  of  fatts  even  with  this  two-fold  teftimony, 
till  future  opportunities,  or  the  obiervations  of  others,  concur  in 
their  fupport. 

Ignorance  and  credulity  have  ever  been  companions,  and  have 
rnifled  and  enflaved  mankind  ;  philoiophy  has  in  all  ages  en- 
deavoured to  oppofe  their  progrefs,  and  to  loofen  the  (hackles 
they  had  impoied  ;  philofophers  have  on  this  account  been  called 
unbelievers  :  unbelievers  of  what  ?  of  the  fictions  of  fancy,  of 
witchcraft,  hobgobblins,  apparitions,  vampires,  fairies  ;  of  the 
influence  of  ftars  on  human  actions,  miracles  wrought  by  the 
bones  of  faints,  the  flights  of  ominous  birds,  the  predictions 
from  the  bowels  of  dying  animals,  expounders  of  dreams,  for- 
tune-tellers, conjurors,  modern  prophets,  necromancy,  cheiro- 
mancy, animal  magnetifm.,  metallic  tra£tors5  with  endlefs  varie- 


CLASS  III.  2.  2.  4.        OF  VOLITION.  35 1 

ty  of  folly  ?  Thefe  they  have  difbelieved  andidefpifed,  but  have 
ever  bowed  their  hoary  heads  to  Truth  and  Nature. 

Mankind  may  be  divided  in  refpecl:  to  tljfc  facility  of  their  be-- 
lief or  convidl ion  into  two  claries  ;  thofe,  who  are  ready  to  af- 
fent  to  fmgle  fads  from  the  evidence  of  their  fenfes,  or  from  the 
ferious  afiertions  of  others  ;  and  thole,  who  require  analogy  to 
corroborate  or  authenticate  them. 

Our  firft  knowledge  is  acquired  by  our  fenfes  *,  but  thefe  are 
liable  to  deceive  us,  and  we  learn  to  detect  thefe  deceptions  by 
comparing  the  ideas  prefented  to  us  by  one  fenfe  with  thofe  prc- 
fented  by  another.  Thus  when  we  firft  view  a  cylinder,  it  ap- 
pears to  the  eye  as  a  flat  furface  with  different  (hades  on  it,  till  we 
correct  this  idea  by  the  fenfe  of  touch,  and  find  its  furface  to  be 
circular  ;  that  is,  having  fome  parts  gradually  receding  further 
from  the  eye  than  others.  So  when  a  child,  or  a  cat,  or  a  bird, 
firft  fees  its  own  image  in  a  looking-glafs,  it  believes  that  anoth- 
er animal  exifts  before  it,  and  detects  this  fallacy  by  going  be- 
hind the  glafs  to  examine,  if  another  tangible  animal  really  exiiis 
there. 

Another  exuberant  fource  of  error  confifts  in  the  falfe  notions, 
which  we  receive  in  our  early  years  from  the  defign  or  ignorance 
of  our  inftructors,  which  affect  all  our  future  reafoning  by  their 
perpetual  intrufions  ;  as  thofe  habits  of  mufcular  actions  of  the 
face  or  limbs,  which  are  called  tricks,  when  contracted  in  infan- 
cy continue  to  the  end  of  our  lives. 

A  third  great  fource  of  error  is  the  vivacity  of  our  ideas  o£ 
imagination,  which  perpetually  intrude  themfelves  by  various 
aflbciations,  and  compofe  the  farrago  of  our  dreams ;  in  which, 
by  the  fufpenfion  of  volition,  we  are  precluded  from  comparing 
the  ideas  of  one  fenfe  with  thofe  of  another,  or  the  incongruity 
of  their  fucceflions  with  the  ufuaicourfe  of  nature,  and  thus  to 
detect  their  fallacy.  Which  we  do  in  our  waking  hours  by  a 
perpetual  voluntary  exertion,  a  procefs  of  the  mind  above  men- 
tioned, which  we  have  termed  intuitive  analogy.  Seel.  XVII. 

3-  7-. 

This  analogy  prefuppofes  an  acquired  knowledge  of  things, 
hence  children  and  ignorant  people  are  the  moil  crodulous,as  not 
poflefling  much  knowledge  of  the  ufual  courfe  of  nature  ;  and 
fecondly,  thofe  are  mod  credulous,  whofc  faculty  of  comparing 
ideas,  or  the  voluntary  exertion  of  it,  is  flow  or  imperfect.  Thus 
if  the  power  of  the  magnetic  needle  of  turning  towards  the  north, 
or  the  {hock  given  by  touching  both  fides  of  an  electrized  coat- 
ed  jar,  was  related  for  the  firft  time  to  a  phibfopher,  and  to  an 
ignorant  perfon  ;  the  former  would  be  lefs  ready  to  believe  them, 
than  the  htter  ;  as  he  would  find  nothing  fimilar  in  nature  to 

CO."- 


3$a  DISEASES  CLASS  III.  2. 2. 4. 

compare  them  to,  he  would  again  and  again  repeat  the  experi- 
ment, before  he  would  give  it  his  entire  credence  ;  till  by  thefe 
repetitions  it  would  ceafe  to  be  a  fingle  fact,  and  would  there- 
fore gain  the  evidence  of  analogy.  But  the  latter,  as  having  lefs 
knowledge  of  nature,  and  lefs  facility  of  voluntary  exertion, 
would  more  readily  believe  the  afiertions  of  others,  or  a  fingle 
fact,  as  prefented  to  his  own  obfervation.  Of  this  kind  are  the 
bulk  of  mankind  ;  they  continue  throughout  their  lives  in  a  ftate 
of  childhood,  and  have  thus  been  the  dupes  of  priefts  and  poli- 
ticians in  all  countries  and  in  all  ages  of  the  world. 

In  regard  to  religious  matters,  there  is  an  intellectual  coward- 
ice inftilled  into  the  minds  of  the  people  from  their  infancy ; 
which  prevents  their  inquiry  :  credulity  is  made  an  indifpenfable 
virtue  •,  to  inquire  or  exert  their  reafon  in  religious  matters  is  de- 
nounced as  finful ;  and  in  the  catholic  church  is  puniflied  with 
more  fevere  penances  than  moral  crimes.  But  in  rcfpecl;  to 
our  belief  of  the  fuppofed  medical  facts,  which  are  publiihed  by 
Variety  of  authors  ;  many  of  whom  are  ignorant,  and  therefore 
credulous  ;  the  golden  rule  of  David  Hume  may  be  applied 
with  great  advantage.  «  When  two  miraculous  affertions  op- 
pofe  each  other,  believe  the  lefs  miraculous."  Thus  if  a  perfon 
is  faid  to  have  received  the  fmall-pox  a  fecond  time,  and  to  have 
gone  through  all  the  ftages  of  it,  one  may  thus  reafon  :  twenty 
thoufand  people  have  been  expofed  to  the  variolous  contagion 
a  fecond  time  without  receiving  the  variolous  fever,  to  every 
one  who  has  been  faid  to  have  thus  received  it ;  it  appears 
therefore  lefs  miraculous,  that  the  afiertor  of  this  fuppofed  fa£fc 
has  been  deceived,  or  wifties  to  deceive,  than  that  it  has  fo  hap- 
pened contrary  to  the  long  experienced  order  of  nature. 

M.  M.  The  method  of  cure  is  to  iricreafe  our  knowledge  of 
the  laws  of  nature,  and  our  habit  of  comparing  whatever  ideas 
are  prefented  to  us  with  thofe  known  laws,  and  thus  to  coun- 
teract the  fallacies  of  our  fenfes,  to  emancipate  ourfelves  from 
the  falfe  impreflions,  which  we  have  imbibed  in  our  infancy,  and 
to  fet  the  faculty  of  reafon  above  that  of  imagination. 


CLASS  IV.  OF  ASSOCIATION,  353 

The  Orders  and  Gener*  of  the  Fourth  Clafs  of  Difeafes* 
CLASS   IV. 

blSEASES   OF   ASSOCIATION. 

ORDO  I. 

Increased  Affodate  Motions. 
GENERA. 

1.  Catenated  with  irritative  motions* 

2.  Catenated  with  fenfitive  motionSo 

3.  Catenated  with  voluntary  motions. 

4.  Catenated  with  external  influences. 

ORDO  II. 

Decreafed  Affbciate  Motienf* 
GENERA. 

1.  Catenated  with  irritative  motions* 

2.  Catenated  with  fenfitive  motions. 

3.  Catenated  with  voluntary  motions. 

4.  Catenated  with  external  influence*. 

ORDO  III. 

Retrograde  Affbciate  Motions. 
GENERA. 

1.  Catenated  with  irritative  motions. 

2.  Catenated  with  fenfitive  motions. 

3-  Catenated  with  voluntary  motions; 

4-  Catenated  with  external  influences. 


.  H. 


354  DISEASES  CLASS IV.  i.  i. 


The  Orders,  Genera,  and  Species,  of  the  Fourth  Clafs  of 

Difeafes. 

CLASS    IV. 

DISEASES    OF    ASSOCIATION. 

ORDO  I. 

Increased  Affociate  Motions. 

GENUS  I. 

Catenated  •with  Irritative  Motions. 
SPECIES. 

r.  Rubor  whits  pranforum.        Flufhing  of  the  face  after  din- 
ner. 

2.  Stidorjlragulis  immerforum.     Sweat  from  covering  the  face 

in  bed. 

3.  Ccffatio  xgritudinis  cute  ex-     Cure  of  ficknefs  by  ftimulating 

citata.  the  fkin. 

4.  Digeftio  auRa  f rigor e  cuta-     Digeftion    increafed   by  cold- 

neo.  nefs  of  the  fkin. 

5.  Catarrhus  afrigore  cutaneo.     Catarrh  from  cold  fkin. 

6.  Abforpt'io    cellularis    aucta     Cellular    abforption    increafed 

vomttu.  by  vomiting. 

7.  Singultus  nephriticus.  Nephritic  hiccough. 

8.  Febris  irritativa.  Irritative  fever. 

GENUS  II. 
Catenated  •with  Senfitive  Motions. 

SPECIES, 
i.  Lacrymarum  fluxus fynpa-     Sympathetic  tears. 

theticus. 
1.   Sternutatio  a  famine.  Sneezing  from  light. 

3.  Dolor  dentium  a  Jlridore.        Tooth-edge    from    grating 

founds. 

4.  Rifus  fardonicus.  Sardonic  fmile. 

5.  Saliva  fluxits  cibo  i)lfo.  Flux  of  faliva  at  fight  of  food. 

6.  Tenfio    niammularum    i)ifo     Tenfioh  of  the  nipples  of  lac- 

puerulo.  tefcent  women  at  fight  of 

the  child. 

7.  Tenfio  penis  in  hydrophobia.     Tenfion  of  the  penis  in  hydro- 

phobia. 

8.  Tenefmus 


CLASS  IV.  i.  3.        OF  ASSOCIATION. 


355 


8.  Tenefmus  calculofus. 

9.  Polypus  narium  ex  afcaride. 

I  o.  Grampus  fur  arum  in  diar- 
rhoea. 

1 1 .  Zona  ignea  nephritiea. 

12.  Eruptio  variolarum. 

13.  Gutta  rofea Jlomatica. 

14.  — bepatica, 

15.  Podagra. 

1 6.  Rheumatifimts. 

17.  Eryfipe/as. 

1 8 .  Teftium  tumor  in  gonorrhoea. 

19.  '  in  parotitide. 


Tenefmus  from  ftone. 
Polypus  of  the  nofe  from  af- 

carides. 
Cramp  from  diarrhoea. 

Nephritic  fhingles. 

Eruption  of  fmall-pox. 

Stomatic  rofy  drop. 

Hepatic  rofy  drop. 

Gout. 

Rheumatifm. 

Eryfipelas. 

Swelled  teftis  in  gonorrhoea. 

. in  mumps. 


GENUS  III. 

Catenated  with  Voluntary  Motions 
SPECIES. 

Deglutitio  invita. 
Niflitatio  invita. 
Rifus  invitus. 
Lufus  digitorum  invitus. 


Involuntary  deglutition. 

nictitation. 

laughter. 

actions   with 


ths 


5.  Unguium  morjiunculq  invita. 

6.  Vigilia  invita. 


ringers. 


biting  the  nails, 
watchfulnefs. 


GENUS  IV. 

Catenated  with  External  Influences, 
SPECIES. 

Life  of  an  egg. 

Life  of  winter-fleepers. 

Budding  of  trees. 

Periods  of  venereal  defire. 

Electric  fhock  through  the  arm. 

Oxygenation  of  the  blood. 

Humeclation  of  the  body. 


1.  Vita  ovi. 

2.  Vita  biemi-dormientium* 

3.  Pullulatio  arborum. 

4.  Qrgafmatis  venerei  periodus. 

5.  Brachii  concujjio  eleftrica. 

6.  Oxygenatio  fanguinis. 

7.  Humeftatio  corporis. 


ORDO  II. 

Decreafed  Ajjbciate  Motions. 

GENUS  I. 
Catenated  with  Irritative  Motions. 

SPECIES, 
i.  Cutis  frigida  pranforuirt.        Chillnefs  after  dinner. 


2.  Pallor 


DISEASES 


CLASS  IV.  2.  i. 


8. 
9. 

TO. 
I  j  . 

1  2. 


1  6. 
1  7. 


Pallor  urina  pranjbrum.          Pale  urine  after  dinner. 
afrigore  cutaneo. from  cold  fkin. 


Pallor  ex  agritudine. 
Dyfpn<zaabalneofrigido. 


Palenefs  from  ficknefs. 
Shortnefs  of  breath  from  cold 

bathing. 

Indigeftion  from  cold  feet. 
Cough  from  cold  feet. 
Liver-cough. 
Gout-cough. 
Vertigo  rotatory. 
•.     '     '  '  vifual. 

• inebriate. 

• feverifli. 

• •  from  the  brain. 


Dyfpepjia  a  pedibus^ 
Tujfis  a  pedibus  frigidis* 
—  hepatica. 

arthritica. 

Vertigo  rotatoria,. 

—  vifua/if. 

•.*  ehriofa. 

-.  ..   i.  ..  febriculofa* 

cerebrofa. 
Murmur  auriutn  vertigin-     Noife  in  the  ears. 

ofum. 
Tatlusy  gujfas,  olfaclns  ver-    Vertiginous  touch,  tafte,  fmelj* 

tiginoji. 
Pulfus  mollis  a  vomitione.        Soft  pulfe  in  vomitting. 

irtermittens  a  ven-    Intermittent    pulfe  from   the 

triculo.  ftomach. 

Ffbris  inirritativa.  Inirritative  fever. 


G£NUS  II. 

Catenated  with  Sefifitive  Motions. 
SPECIES. 

^ .  Torpor  gena  a  dolors  dentis.     Coldnefs   of  the  cheek   from 

tooth-ach. 
2.  Stranguria  a  ddore  veftca.       Strangury   from  pain  of   the 

bladder. 
convulfiva.  Convulfive  ftrangury. 


3-  — 

4.  Dolor  termini  duftus  chole- 

dochi. 

5 .  Dolor  pbaryngis  abacido  gaf- 

trico. 

6.  Pruritus  narium  a  vermibus. 
j.   Cephaltea. 

8.  Hemicrania  et  otalgia. 

9.  Dolor  humeri  in  hepatidide* 
\  O.  Torpor  pfdutn  variola  erum- 

pentf. 

II.   Teflium  dolor  nepkriticus. 
3  2.  Dolor  digiti  minimi  fympa- 

theticus* 


Pain  of  the  end  of  the  bile- 


Pain  of  the  throat  from  gaftric 

acid. 

Itching  of  thenofe  from  worms. 
Head-ach. 

Partial  head-ach,  and  ear-ach. 
Pain  of  moulder  in  hepatitis. 
Cold  feet  in  eruption  of  fmall- 

pox. 

Nephritic  pain  of  teftis. 
Pain  of  little  finger  from  fym- 

pathy. 

13.  Dolor 


CLASS  IV.  2. 3.          OF  ASSOCIATION.  3*7 

13.  Dolor  brachii  in  hydrope  pec-     Pain  of  the  arm  in  drop  fy  of 

tons.  the  cheil. 

14.  Diarrhoea  a  dentitions.  Diarrhoea  from  toothing. 

GENUS  III. 

Catenated  'with  Voluntary  Motions. 
SPECIES. 

1.  Titubatio  lingua.  Impediment  of  fpcech. 

2.  Chorea  fan  fti  Viti*  St.  Vitus'  dauce. 

3.  Rifus.  Laughter. 

4.  Tremore  ex  ira.  Trembling  from  anger. 

5.  Ruhr  ex  ird.  Rednefs  from  anger. 

6.   criminati.  Blufli  of  guilt. 

7.  Tarditas  paralytics.  Slownefs  from  palfy. 

8.  femlis.  of  age. 

GENUS  IV. 

Catenated  with  External  Influences. 
SPECIES. 

1.  Somni periodus.  Periods  of  fleep. 

2.  Studii  inanis  periodus.  of  reverie. 

3.  Hemicrania  periodus.  _— .  of  head-ach. 

4.  Epilepfue  dolorificx  periodus.     of  painful  epilepfy. 

5.  Convulfionis  dolor ificx  peri-  of  painful  convulfion. 

odus. 

6.  Tujfis  periodic*  pe riodus.  of  periodic  cough. 

7.  Catamenix  periodus. of  catamenia. 

8.  Ha morrhoidis  periodus.  —  of  the  piles. 

9.  Podagra  periodus. •  of  the  gout. 

10.  Eryfipilatis periodus.  of  eryfipelas* 

1 1 .  Febrium  periodus*  of  fevers. 

ORDO  III.      . 

Retrograde  Affociate  Motions. 

GENUS  I. 

Catenated  ivith  Irritative  AlotionS. 
SPECIES. 

1.  Diabetes  irritata.  Diabetes  from  irritation. 

2.  Sudor  frigidus  in  aflhmate.     Cold  fweat  in  afthma. 

3.  Diabetes  a  timore.  Diabetes  from  fear. 

4.  Diarrhoea  $  timore.  Diarrhoea  from  fear. 

Pallor 


35$  DISEASES  CLASS  IV.  3.  *. 

5.  Pallor  et  tremor  a  timore.        Palenefs  and  trembling  from 

fear. 

6.  Palpltatlo  cordls  a  timore.        Palpitation  of  the  heart  from 

fear. 

7.  Abortio  a  timore.  Abortion  from  fear. 
£.  Hyfteria  a  timore.                    Hyfterics  from  fear. 

GENUS  II. 

Catenated  with  Senfitlve  Motions. 
SPECIES. 

1.  Nattfea  Idealls.  Naufea  from  ideas. 

2.  a  conceptu.  Naufea  from  conception. 

3.  Vomitio  vertiginofa.  Vomiting  from  vertigo. 

4.  a  calculo  in  ureter e.     — —  from  {tone  in  the  u- 

reter. 

ab  infultu  paralyt- from  ftroke  of  palfy. 

ico. 

a  titillatione  fau- from    tickling    the 

clum.  throat. 

•7.       .         cute  fympathetlca.       •  from  fympathy  with 

the  fkin. 

GENUS    III. 

Catenated  with  Voluntary  Motions. 
SPECIES. 

1.  Rummatlo.  Rumination. 

2.  Vomitio  voluntaria.  Voluntary  vomiting. 

3.  Erufiatio  voluntaria. eructation. 

GENUS  IV. 

Catenated  -with  External  Influences. 
SPECIES. 

1 .  Catarrhus  periodicus.  Periodical  catarrh. 

2.  TuJ/is  periodica.  Periodic  cough. 

3.  Hyfteria  a  f rigor e.  Hyfterics  from  cold. 

4.  Nattfea  pluvialis.  Sicknefs  againft  rain. 


CLASS 


CLASS  IV.  i.  r;        OF  ASSOCIATION.  359 

CLASS  IV. 

DISEASES  OF  ASSOCIATION. 

ORDO  I. 

Increafed  Ajficiate  Motions. 

GENUS  I. 
Catenated  with  Irritative  Motions. 

THE  importance  of  the  fubfequent  clafs  not  only  confifts  in 
its  elucidating  all  the  fympathetic  difeafes,  but  in  its  opening  a 
road  to  the  knowledge  of  fever.  The  difficulty  and  novelty  of  the 
fubject  mult  plead  in  excufe  for  the  prefent  imperfect:  ftate  of 
it.  The  reader  is  entreated  previoufly  to  attend  to  the  follow- 
ing circumftances  for  the  greater  facility  of  inveftigating  their 
intricate  connections  ;  which  I  (hall  enumerate  under  the  fol- 
lowing heads. 

A.  Affociate  motions  diftinguifhed  from  catenations. 

B.  Aflbciate  motions  of  three  kinds. 

C.  Aflbciations  affected  by  external  influences. 

D.  Aflbciations  affected  by  other  fenforial  motions. 

E.  Aflbciations  catenated  with  fenfation. 

F.  Direct  and  reverfe  fympathy. 

G.  Aflbciations  affected  four  ways. 
H.   Origin  of  aflbciations. 

I.     Of  the  action  of  vomiting. 
K.   Tertian  aflbciations. 

A.  Affociate  Motions  diftingitijhed from  Catenations. 

Aflbciate  motions  properly  mean  only  thofe,  which  are  caufed 
by  the  fenforial  power  of  aflbciation.  Whence  it  appears,  that 
thofe  fibrous  motions,  which  conftitute  the  introductory  link  of 
an  aflbciate  train  of  motions,  are  excluded  from  this  definition, 
as  not  being  themfelves  caufed  by  the  fenforial  power  of  aflbcia- 
tion, but  by  irritation,  or  fenfation,  or  volition.  I  fhall  give  for  ex- 
ample theflulhing  of  the  face  after  dinner  ;  the  capillary  vefltls  of 
the  face  increafe  their  actions  in  confequence  of  their  catenation, 
not  their  aflbciation,  with  thofe  of  the  ftomach  ;  which  latter  are 
caufed  to  act  with  greater  energy  by  the  irritation  excited  by 
the  (timulus  ofxfood.  Thefe  capillaries  of  the  face  are  aflbcia- 

ted 


360  DISEASES  CLASS IV.  i.  x, 

ted  with  each  other  reciprocally,  as  being  all  of  then!  excited 
by  the  fenJforial  power  of  aflbciation  ;  but  they  are  only  catenated 
•with  thofe  of  the  ftomach,  which  are  not  in  this  cafe  aflbciate 
motions  but  irritative  ones.  The  common  ufe  of  the  word  af- 
fociation  for  almoft  every  kind  of  connection  has  rendered  this 
fubject  difficult  *  from  which  inaccuracy  I  fear  fome  parts  of  this 
work  are  not  exempt. 

B.  jAffociate  Motions  cf 'three  Kinds. 

Thofe  trains  or  tribes  of  aflbciate  motions,  the  introductory 
links  of  which  confifts  of  an  irritative  motion,  are  termed  irrita* 
live  aflbciations  ;  as  when  the  mufcles  of  the  eyelids  clofe  the 
eye  in  common  nictitation.  Thofe,  whofe  introductory  link 
confiftsof  afenfitive  motion,  are  termed  fenfitive  aflbciations  ;  as 
when  the  pectoral  and  intercoflal  mufcles  act  in  fneezing. 
And  laftly,  thofe  whofe  introductory  link  confifts  of  a  voluntary 
motion,  are  termed  voluntary  aflbciations ;  as  when  the  mufclea 
of  the  lower  limbs  act  in  concert  with  thofe  of  the  arm  in  fencing. 

C.  AJJociations  affected  by  external  Influences. 

Circles  of  aflbciate"1  motions,  as  well  as  trains  and  tribes  of 
them,  are  liable  to  be  affected  by  external  influences,  which  con- 
(ift  of  ethereal  fluids,  and  which,  by  penetrating  the  fyftem,  act 
upon  it  perhaps  rather  as  a  caufa  fine  qua  nonof  its  movements, 
than  directly  as  a  ftimulus  ;  except  when  they  are  accumulated 
in  unufual  quantity.  We  have  a  fenfe  adapted  to  the  perception 
of  the  excefs  or  defect  of  one  of  thefe  fluids  ;  I  mean  that  of 
elementary  heat ;  in  which  all  things  are  immerfed.  See  Clafs 
IV.  i  4.  i.  But  there  are  others  of  them,  which  as  we  have 
no  power  to  evade  their  influence,  fo  we  have  no  fenfe  to  per- 
ceive it  j  thefe  are  the  folar,  and  lunar,  and  terreftrial  gravitation, 
in  which  alfo  all  things  are  immerfed  •,  the  electric  aura,  which 
pervades  us,  and  is  perpetually  varying.  See  Clafs  IV.  i.  4. 
5  ;  the  magnetic  fluid,  Clafs  IV.  i.  4.  6  ;  and  laftly,  the  great 
life-preferver  oxygen  gas,  and  the  aqueous  vapour  of  the  atmof- 
phere,  fee  Clafs  IV.  i.  4.  6.  and  7.  and  2. 

Of  thefe  external  influences  thofe  of  heat,  and  of  gravity, 
have  diurnal  periods  of  increafe  and  decreafe  5  befides  their 
greater  periods  of  monthly  or  annual  variation.  Tke  manner 
in  which  they  act  by  periodical  increments  on  the  fyftem,  till 
fome  effect  is  produced,  is  fpoken  of  in  Sect.  XXXII.  3.  and  6, 


AJJociationt 


CLASS IV.  1. 1.         OF  ASSOCIATION.  Z6t 

D.  AJJbctations  affefted  by  other  Senforial  Motions, 

Circles  and  trains  of  affociate  motions  are  alfo  liable  to  be  af- 
fected by  their  catenations  with  other  fenforial  powers,  as  of  ir- 
ritation, or  fenfation,or  volition  •,  which  other  fenforial  powers  ei- 
ther thus  fimply  form  fome  of  the  links  of  the  catenation,  or  add 
to  the  energy  of  the  aflbciated  motions.  Thus  when  vomiting 
is  caufed  by  the  ftimulus  of  a  ftone  in  the  ureter,  the  fenfation  of 
pain  feems  to  be  a  link  of  the  catenation  rather  than  an  efficient 
caufe  of  the  vomiting.  But  when  the  capillary  veffels  of  the 
fldn  increafe  their  action  from  the  influence  of  external  heat, 
they  are  excited  both  by  the  ftimulus  of  unufual  heat,  as  well 
as  by  the  ftimulus  of  the  blood,  and  by  their  accuftomed  affoci- 
ation  with  the  actions  of  the  heart  and  arteries.  And  laftly,  in 
the  blufh  of  anger  the  fenforial  power  of  volition  is  added  to 
that  of  affociation,  and  irritation,  to  excite  the  capillaries  of  the 
face  with  increafed  action.  See  Clafs  IV.  2.  3.  5. 

E.  djjociations  catenated  'with  Senfation* 

Pain  frequently  accompanies  affociate  trains  or  circles  of  mo- 
tion without  its  being  a  caufe,  or  a  link,  of  them,  but  fimply  an 
attendant  fymptom  •,  though  it  frequently  gives  name  to  the 
difeafe,  as  head-ach.  Thus  in  the  cramp  of  the  calves  of  the 
legs  in  diarrhoea,  the  increafed  fenforial  power  of  aflbciation  is 
the  proximate  caufe  ;  the  preceding  increafed  action  of  the  bow- 
els is  the  remote  caufe  ;  and  the  proximate  effect  is  the  violent 
contractions  of  the  mufculi  gaftrocnemii ;  but  the  pain  of 
thefe  mufcles  is  only  an  attendant  fymptom,  or  a  remote  effect. 
See  Sect.  XVIII.  15.  Other  fenfitive  aflbciat ions  are  mention- 
ed in  Clafs  IV.  I.  2.  and  IV.  i.  2.  15. 

Thus,  if  the  flufhing  of  the  face  above  mentioned  after  dinner 
be  called  a  difeafe,  the  immediate  or  proximate  caufe  is  the  in- 
creafed power  of  aflbciation,  the  remote  caufe  is  the  increaf- 
ed irritative  motions  of  the  ftomach  in  confequence  of  the  ftim- 
ulus of  food  and  wine.  The  difeafe  or  proximate  effect  confifts 
in  the  increafed  actions  of  the  cutaneous  veffels  of  the  face  ;  and 
the  fenfation  of  heat,  the  exiftence  of  heat,  and  the  red  colour, 
are  attendants  or  fymptoms,  or  remote  effects,  of  the  increafed 
actions  of  thefe  cutaneous  veffels. 

F.   Direfl  andreverfe  Sympathy* 

The  increafed  actions  of  the  primary  part  of  the  trains  of  af- 

fociated  motions  are  fomctimes  fucceeded  by  increafed  actions 

VOL.  IL  Y  Y  of 


3<$2  DISEASES  CLASS  IV.  i.  i, 

of  the  fecondary  part  of  the  train  ;  and  fometimes  by  decreafed 
aliens  of  it.  So  likewife  the  decreafed  actions  of  the  primary 
part  of  a  train  of  aflbciate  motions  are  fometimes  fucceeded  by 
decreafed  actions  of  "the  fecondary  part,  and  fometimes  by 
increafed  actions  of  it.  The  former  of  thefe  fituations  is  called 
direct  fympathy,  and  the  latter  reverfe  fympathy.  In  general  I 
believe,  where  the  primary  part  of  the  train  of  aflbciated  motions 
is  exerted  more  than  natural,  it  produces  direct  fympathy  in 
flrong  people,  and  reverfe  fympathy  in  weak  ones,  as  a  full  meal 
makes  fome  people  hot,  and  others  chill.  And  where  the  pri- 
mary part  of  the  train  is  exerted  lefs  than  natural,  it  produces 
direct  fympathy  in  weak  people,  and  reverfe  fympathy  in  ftrong 
ones,  as  on  being  expofed  for  a  certain  length  of  time  on  horfe- 
back  in  a  cold  day  gives  indigeftion  and  confequent  heart-burn 
to  weak  people,  and  ftrengthens  the  digeftion,  and  induces  con- 
fequent hunger  in  ftrong  ones.  See  Sect.  XXXV.  i. 

This  may  perhaps  be  more  eafily  underftood,  by  confidering 
ftrength  and  weaknefs,  when  applied  to  animal  bodies,  as  con- 
fifting  in  the  quantity  of  fenforial  power  refiding  in  the  con- 
tracting fibres,  and  the  quantity  of  flimulus  applied,  as  fhewn 
in  Sect.  XII.  2.  i.  Now  when  defective  flimulus,  within  certain 
limits,  is  partially  applied  to  parts  fubject  to  perpetual  motion, 
the  expenditure  of  fenforial  power  is  for  a  while  leflened,  but 
not  its  general  production  in  the  brain,  nor  its  derivation  into 
the  weakly  ftimulated  part.  Hence  in  ftrong  people,  or  fuch 
whofe  fibres  abound  with  fenforial  power,  if  the  firft  tribe  of  an 
aflbciate  train  of  motions  be  deprived  in  part  of  its  accuftomed 
flimulus,  its  action  becomes  diminifhed  ;  and  the  fenforial  pow- 
er becomes  accumulated,  and  by  its  fuperabundance,  or  over- 
flowing as  it  were,  increafes  the  action  of  the  fecond  tribe  of 
the  aflbciate  actions  by  reverfe  fympathy.  As  expofing  the 
warm  ikin  for  a  moderate  time  to  cold  air  increafes  the  action 
of  the  ftomach,  and  thus  ftrengthens  the  power  of  digeftion. 

On  the  reverfe,  when  additional  ftimulus  within  certain  lim- 
its is  partially  applied  to  parts,  which  are  deficient  in  refpect  to 
the  natural  quantity  of  fenforial  power,  the  expenditure  of  fen- 
forial power  is  increafed,  but  in  a  lefs  degree  than  the  increafed 
production  of  it  in  the  brain,  or  its  increafed  derivation  into  the 
flrongly-ftimulated  organ.  Hence  in  weak  people,  or  fuch 
whole  fibres  are  deficient  of  fenforial  power,  if  the  firft  tribe  of 
an  aflbciate  train  of  motions  be  fubjected  for  a  while  to  greater 
ftimulus  than  ufual,  a  greater  production  of  fenforial  power,  or 
a  greater  derivation  of  it  into 'the  ftimulated  parts  occurs  ;  which 
by  its  excefs,  or  overflowing  as  it  were,  increafes  the  actions  of 
the  feccmd  tribe  of  the  aflbciate  motions  by  direct  fympathy. 

Thus 


CLASS  IV.  1. 1.          OF  ASSOCIATION.  363 

Thus  when  vomiting  occurs  with  cold  extremities,  a  blifter  on 
the  back  in  a  few  hours  occafions  univerfal  warmth  of  the  fkin, 
and  flops  the  vomiting.  And  when  a  diarrhoea  occurs  with  pale 
fkin  and  cold  extremities,  the  pricking  of  the  points  of  a  flannel 
(hirt,  worn  next  the  fkin,  occafions  univerfal  warmth  of  it,  and 
checks  or  cures  the  diarrhoea. 

In  fome  aflbchte  trains  of  action  neverthelefs  reverfe  fympa- 
thies  more  frequently  occur  than  direct  ones,  and  in  others  di- 
rect ones  more  frequently  than  reverfe  ones.  Thus  in  continu- 
ed fever  with  debility  there  appears  to  be  a  reverfe  fympathy  be- 
tween the  capillary  veflels  of  the  ftomach  and  thofe  of  the  fkin  ; 
becaufe  there  exifts  a  total  averfion  to  folid  food,  and  conftant 
heat  on  the  furface  of  the  body.  Yet  thefe  two  fyftems  of  vef- 
fels  are  at  other  times  actuated  by  direct  fympathy,  as  when 
palenefs  attends  ficknefs,  or  cold  feet  induces  indigeilion.  This 
fubject  requires  to  be  further  inveftigated,  as  it  probably  depends 
not  only  on  the  prefent  or  previous  plus  or  minus  of  the  fenfo- 
rial  power  of  afibciation,  but  alfo  on  the  introduction  of  other 
kinds  of  fenforial  power,  as  in  Clafs  IV.  I.  I.  D  ;  or  the  in- 
creafed  production  of  it  in  the  brain,  or  the  greater  mobility  of 
one  part  of  a  train  of  actions  than  another. 

Thus  when  much  food  or  wine  is  taken  into  the  ftomach,  if 
there  be  no  fuperfluity  of  fenforial  power  in  the  fyftem,  that  is, 
none  to  be  fpared  from  the  continual  actions  of  it,  a  palenefs  and 
chillnefs  fucceed  for  a  time  ;  becaufe  now  the  expenditure  of 
it  by  the  increafed  actions  of  the  ftomach  is  greater  than  the 
prefent  production  of  it.  In  a  little  time  however  the  ilimulus 
of  the  food  and  wine  increafes  the  production  of  fenforial  pow- 
er in  the  brain,  and  this  produces  a  fuperfluity  of  it  in  the  fyf- 
tem *,  in  confequence  of  which  the  fkin  now  becomes  warm 
and  florid,  which  was  at  firft  cold  and  pale  •,  and  thus  the  reverfe 
fympathy  is  fhortly  converted  into  a  direct  one  ;  which  is  prob- 
ably owing  to  the  introduction  of  a  fecond  fenforial  power,  that 
of  pleafurable  fenfation. 

On  the  contrary,  when  an  emetic  drug  produces  ficknefs,  the 
(kin  is  at  firft  pale  for  a  time  by  direct  fympathy  with  the  capil- 
laries of  the  ftomach ;  but  in  a  few  minutes,  by  the  accumula- 
tion of  fenforial  power  in  the  ftomach  during  its  lefs  active  ftate 
in  ficknefs,  the  capillaries  of  the  ikin,  which  are  aflbciated  with 
thofe  of  the  ftomach,  act  with  greater  energy  by  reverfe  fympa- 
thy, and  a  florid  colour  returns.  Where  the  quantity  of  action 
is  diminifhed  in  the  firft  part  of  a  train  of  motions,  whether  by 
previous  diminution  of  fenforial  power,  or  prefent  diminution 
of 'ftimulus,  the  fecond  part  of  the  train  becomes  torpid  by  di- 
rect fympathy.  And  when  the  quantity  of  action  of  the  firft 

part 


36*4  DISEASES  CLASS IV.  i.  i. 

part  becomes  increafed  by  the  accumulation  of  fenforial  power 
during  its  previous  torpor,  or  by  increafe  of  ftimulus,  the  actions 
of  the  fecond  part  of  it  likewife  become  increafed  by  direct  fym- 
pathy. 

In  moderate  hunger  the  f]dn  is  pale,  as  before  dinner,  and  in 
moderate  ficknefs,  as  no  great  accumulation  of  fenforial  power 
has  commenced  ;  but  in  violent  hunger,  and  in  greater  torpor  of 
the  ftomach,  as  from  contagious  matter,  the  accumulation  of 
fenforial  power  becomes  fo  great  as  to  affect  the  arterial  and 
capillary  fyftem,  and  fever  is  produced  in  both  cafes. 

In  contagious  fevers  with  arterial  debility  commencing  with 
torpor  of  the  ftomach,  why  is  the  action  of  the  heart  weakened, 
and  that  of  the  capillaries  increafed  ?  Is  it  becaufe  the  mobility 
of  the  heart  is  lefs  than  that  of  the  ftomach,  and  the  mobility  of 
the  capillaries  greater  ?  Or  is  it  becaufe  the  aflbciation  between 
the  mufcular  fibres  of  the  ftomach  and  thofe  of  the  heart  have 
been  uniformly  afibciated  by  direct  fympathy  ;  and  the  capilla- 
ries of  the  ftomach  and  thofe  of  the  fkin  have  been  more  fre- 
quently aflbciated  by  reverfe  fympathy  ? 

Where  the  actions  of  the  ftomach  have  been  previoufly  ex- 
haufted  by  long  ftimulus,  as  on  the  day  after  intoxication,  little 
or  no  accumulation  of  fenforial  power  occurs,  during  the  tor- 
por of  the  organ,  beyond  what  is  required  to  replace  the  defi- 
ciency of  it,  and  hence  fever  feldom  follows  intoxication.  And 
a  repetition  of  the  ftimulus  fometimes  becomes  neceflary  even  to 
induce  its  natural  action,  as  in  dram-drinkers. 

Where  there  has  been  no  previous  exhauftion  of  fenforial 
power,  and  the  primary  link  of  aflbciate  motions  is  violently 
actuated'  by  the  fenforial  power  of  fenfation,  the  fecondary  link 
is  alfo  violently  actuated  by  direct  fympathy  ;  as  in  inflammato- 
ry fevers.  Where  however  the  fenforial  power  of  the  fyftem  is 
lefs  than  natural,  the  fecondary  link  of  afTociated  motions  be- 
comes torpid  by  reverfe  fympathy,  as  in  the  inoculated  fmall-pox 
during  the  eruption  on  the  face  the  feet  are  frequently  cold. 

G.  AJfociatwns  offered  four  Ways. 

Hence  aflbciated  trains  or  circles  of  motions  may  be  affected 
four  different  ways.  i.  By  the  greater  or  lefs  energy  of  action 
of  the  firft  link  with  which  they  are  catenated,  and  from  which 
they  take  their  names;  as  irritative,  fenfitive,  or  voluntary  aflb- 
ciations.  2.  By  being  excited  by  two  or  more  fenforial  powers 
at  the  fame  time,  as  by  irritation  and  aflbciation,  as  in  the  in- 
flance  of  the  application  of  the  ftimulus  of  increafed  external 
heat  to  the  cutaneous  capillaries.  3.  By  catenation  with  other 

fenforial 


CLASS IV.  i.i.        OF  ASSOCIATION.  365 

ienforial  powers,  as  with  pain  or  pleafure,  which  are  in  this  cafe 
not  the  proximate  caufe  of  motion,  but  which,  by  becoming  a 
link  of  catenation,  excite  the  fenforial  power  of  aflbciation  into 
action  j  as  the  pain  at  the  neck  of  the  gall-bladder  occafioned 
by  a  gall-ftone  is  transferred  to  the  other  end  of  that  canal,  and 
becomes  a  link  of  catenation  between  the  aft  ion  of  the  two  ex- 
tremities of  it.  4.  The  influence  of  ethereal  fluids,  as  of  heat 
and  gravitation.  To  which  laft  perhaps  might  be  added  moif- 
ture  and  oxygen  gas  as  conftituting  neceflary  parts  of  the  fyf- 
tem,  rather  than  ftimuli  to  excite  it  into  action, 

H.     The  Origin  of  AJJbciations. 

Some  trains  or  circles  of  aflbciate  motions  muft  have  been 
formed  before  our  nativity,  as  thofe  of  she  heart,  arteries,  and 
capillaries  ;  others  have  been  aflbciated,  as  occafion  required 
them,  as  the  mufcles  of  the  diaphragm  and  abdomen  in  vomit- 
ing ;  and  others  by  perpetual  habit,  as  thofe  of  the  ftomach  with 
the  heart  and  arteries  directly,  as  in  weak  pulfe  during  ficknefs  \ 
with  the  capillaries  directly,  as  in  the  flufhed  Ikin  after  dinner  ; 
and  laftly,  with  the  cellular  abforbents  reverfely,  as  in  the  in- 
creafed  abforption  in  anafarca  during  ficknefs  ;  and  with  the  ir- 
ritative motions  of  the  organs  of  fenfe  reverfely,  as  in  vertigo, 
or  fea-ficknefs.  Some  of  thefe  aflbciations  fnall  be  here  ihortly 
defcribed  to  facilitate  the  inveftigation  of  others. 

Firft,  other  congeries  of  glands  occupy  but  a  particular  part 
of  the  fyftem,  or  conftitute  a  particular  organ,  as  the  liver,  or 
kidneys  ;  but  thofe  glands,  which  fecrete  the  mucus,  and  per- 
fpirable  matter,  which  are  called  capillaries,  are  of  very  great 
extent ;  they  receive  the  blood  from  the  arteries,  feparate  from 
it  the  mucus,  which  lines  every  cell,  and  covers  every  cavity  of 
the  body  ;  and  the  perfpirable  matter,  which  foftens  and  lubri- 
cates the  whole  furface  of  the  fldn,  and  the  more  extenfive  fur- 
face  of  the  air-veflels,  which  compofe  the  lungs.  Thefe  are 
fupplied  with  blood  by  the  perpetual  action  of  the  heart  and  ar- 
teries, and  have  therefore  their  motions  aflbciated  with  the  form- 
er, and  with  each  other,  by  fympathy,  which  is  fometimes  di- 
rect, and  fometimes  reverfe. 

One  branch  of  this  aflbciation,  the  capillaries  of  the  fkin,  is 
very  irritable  by  the  increafed  quantities  of  cold  and  heat ;  anoth- 
er branch,  that  of  the  lungs,  has  not  the  perception  of  cold 
and  heat,  but  is  liable  by  direct  fympathy  to  act  in  concert  with 
the  former,  as  in  going  into  the  cold  bath.  And  it  is  probable 
the  capillaries  of  the  internal  membranes  are  likewife  directly 

affected 


366  DISEASES  CLASS IV.  1. 1. 

affected  by  their  fympathy  with  thofe  of  the  flcin,  as  appears  from 
the  defect  of  fecretion  in  ulcers  during  the  cold  fits  of  agues. 

The  motions  of  this  extenfive  fyftem  of  capillaries,  thus  aflb- 
ciated  by  direct  Tympathy,  are  alfo  alTociated  with  thofe  of  the 
heart  and  arteries,  fometimes  by  reverfe  and  fometimes  by  di- 
rect fympaihy  •,  and  thus  constitute  fimple  fever.  The  cold 
paroxyfm  of  which  confifts  in  their  torpor,  and  the  hot  one  in 
their  orgafm,  or  increafed  activity. 

I.  Of  the  Aftim  of  Vomiting. 

The  manner,  in  which  the  ftomach  and  the  diaphragm  and 
abdominal  mufcles  acquire  their  aflbciate  action  in  vomiting, 
requires  fome  attention.  It  is  not  probable,  that  this  action  of 
vomiting  occurs  before  nativity ;  as  the  uniform  application  of 
the  nutritive  liquor  amnii  to  the  mouth  of  the  foetus,  and  the 
uniform  expenditure  of  its  nourifhment,  would  not  feem  to  give 
occafion  to  too  great  temporary  repletion  of  the  ftomach  ;  and 
would  preclude  the  deglutition  of  any  improper  material.  After 
nativity  the  ftomach  of  the  child  may  be  occafionally  too  much 
diftended  with  milk  ;  as  previous  hunger  may  induce  it  to  over- 
gorge  itfelf  j  and  by  repeated  efforts  the  act  of  vomiting  is  learn- 
ed, as  a  means  of  getting  free  from  a  difagreeable  fenfation. 
Thus  when  any  difguftful  material,  as  a  bitter  drug,  is  taken 
into  the  mouth ;  certain  retrograde  motions  of  the  tongue  and 
lips  are  produced,  for  the  purpofe  of  putting  the  difagreeable 
material  out  of  the  mouth  again. 

When  the  ftomach  is  difagreeably  ftimulated  by  the  diftention 
or  acrimony  of  the  aliment,  a  fimilar  effort  to  regurgitate  it  muft 
occur ;  and  by  repeated  trials  the  action  of  the  diaphragm  and 
abdominal  mufcles  by  fqueezing  the  ftomach  aflifts  its  retro- 
grade exertion  to  difgorge  its  contents.  In  the  fame  manner 
when  a  piece  of  gravel  is  pufhed  into  the  urethra,  or  a  piece  of 
indurated  bile  into  the  neck  of  the  gall-bladder,  after  they  have 
been  in  vain  prelFed  forward  by  the  ufual  motions  of  thofe 
ducts,  they  return  into  the  bladders  of  gall  and  urine  by  the  re- 
trograde motions  of  them. 

That  this  is  one  mode,  in  which  vomiting  is  induced,  appears 
from  the  inflantaneous  rejection  from  the  ftomach  occafioned 
by  fome  naufeous  drug,  or  from  fome  naufeous  idea ;  and  laft- 
ly,  from  the  voluntary  power,  which  fome  people  have  been  faid 
to  have  acquired,  of  emptying  their  ftomachs,  much  in  the  fame 
manner  as  ruminating  animals  bring  up  the  grafs  from  their 
firft  ftomach. 

There  are  neverthelefs  many  modes  by  which  thefe  inverted 

motions 


CLASS  IV.  i.i.        OF  ASSOCIATION.  367 

motions  of  the  ftomach  and  cefophagus  are  induced,  and  which 
it  is  of  confequence  to  diftinguifh  from  each  other.  The  firft 
is  the  mode  above  defcribed,  where  an  effort  is  made  to  diflodge 
ibmething,  which  ftimulates  the  ftomach  into  cfitagreeable  ien- 
fation  ;  and  which  is  returned  by  repeated  exertions  ;  as  when 
a  naufeous  drug  is  taken  into  the  mouth,  or  a  bit  of  fand  falls 
into  the  eye,  or  a  drop  of  water  into  the  wind-pipe.  In  this  the 
periftaltic  motions  of  the  ftomach  are  firft  flopped,  and  then  re- 
verted by  painful  fenfation  ;  and  the  abdominal  mufcles  and  di- 
aphragm by  repeated  efforts  become  affociated  with  them.  Now 
as  lefs  fenforial  power  is  expended  on  the  retrograde  actions  of 
the  ftomach,  and  of  the  lymphatics,  which  open  their  mouths 
on  its  furface,  than  by  their  natural  motions,  an  accumulation 
of  fenforial  power  in  the  fibres  of  the  ftomach  follows  the  ex- 
hibition of  an  emetic,  and  on  that  account  an  emetic  will  fome- 
times  flop  a  fpontaneous  vomiting  which  was  owing  to  fenfori- 
al deficiency.  See  Sett.  XXXV.  1.3.  and  Art.  V.  2.  i. 

As  bitters  and  metallic  falts,  exhibited  in  fmall  dofes,  ftimu- 
late  the  ftomach  into  greater  action,  as  appears  by  their  increaf- 
ing  the  power  of  digeftion,  and  yet  become  emetic,  when  given 
in  larger  dofes  ;  one  might  fufpect,  that  they  became  emetic 
by  inducing  debility,  and  confequent  retrograde  actions  of  the 
ftomach,  by  their  previoufly  exhauiling  the  fenforial  power  by 
their  great  ftimulus  ;  which  might  be  effected  in  a  moment 
without  producing  pain,  and  in  confequence  without  our  per- 
ceiving it.  But  on  the  contrary,  there  does  not.in  general  ap- 
pear on  the  exhibition  of  emetics  to  be  any  previous  exhauftion 
of  fenforial  power  ;  becaufe  there  is  evidently  an  accumulation 
of  it  during  the  ficknefs,  as  appears  from  the  digeftion  being 
ftronger  afterwards ;  and  from  the  increafed  action  of  the  cel- 
lular and  cutaneous  abforbents  during  its  operation.  See  Art. 
V.  2.  i. 

Another  mode  by  which  vomiting  is  induced,  is  owing  to  de- 
bility or  deficiency  of  fenforial  power,  from  the  previous  ex- 
hauftion of  it ;  as  on  the  day  after  intoxication,  or  which  occurs 
in  people  enfeebled  with  the  gout,  and  in  dropfy,  and  in  fome 
fevers  with  debility.  In  thefe,  when  the  vomiting  ceafes,  there 
is  no  appearance  of  accumulation  of  fenforial  power,  as  the  di- 
geftion ftill  remains  weak  and  imperfect. 

Another  mode  by  which  ficknefs  or  vomiting  is  induced,  is 
by  defect  of  ftimulus,  as  in  great  hunger  ;  and  in  thofe,  who 
have  been  habituated  to  fpice  and  fpirit  with  their  mer.ls,  who 
are  liable  to  be  fick  after  taking  food  without  thefe  additional 
ftimuli.  Other  means  of  inducing  ficknefs  by  vertigo,  or  by 
nauieous  ideas,  will  be  mentioned  below. 

We 


3<58  DISEASES  CLASS  IV.  i;  t. 


We  fhall  only  add,  that  the  motions  of  the  mufcular  fibres  of 
the  ftomach  are  aflbciated  with  thofe  of  the  heart  and  arteries 
by  direct  fympathy,  as  appears  by  the  weaknefs  of  the  pulfe 
during  the  exhibition  of  an  emetic  ;  and  that  the  abforbents  of 
the  ftomach  are  aflbciated  with  the  cellular  and  cutaneous  abfor- 
bents by  reverfe  fympathy,  as  is  fhewn  by  the  great  abforption 
of  the  mucus  of  the  cells  in  anafarca  during  ficknefs  •,  at  the 
fame  time  that  the  abforbents  of  the  ftomach  invert  their  actions, 
and  pour  the  mucus  and  water  thus  abibrbed  into  that  vifcus. 

In  cold  paroxyfms  of  fever  the  ftomach  partakes  of  the  gen- 
eral torpor,  and  vomiting  is  induced  by  its  debility,  either  by 
its  aflbciation  with  the  torpid  capillaries,  or  other  torpid  parts,  or 
by  its  own  torpor  commencing  firft,  and  caufing  the  cold  fit. 
The  difordered  motions  of  the  ftomach  frequently  feem  to  be  the 
caufe  or  primary  feat  of  fever,  as  where  contagious  miafrna  are 
fwallowed  with  the  faliva,and  where  fever  is  produced  by  fea-fick- 
nefs,  which  I  once  faw.  Neverthelefs  a  diforder  of  the  ftomach 
does  not  always  induce  fever,  as  in  that  cafe  it  fhould  conftantly 
attend  indigeftion,and  vertigo,  and  fea-ficknefs ;  but  is  itfelf  fre- 
quently induced  by  aflbciation  with  the  difordered  movements  of 
other  parts  of  the  fyftem,  as  when  it  arifes  from  gravel  in  the 
ureter,  or  from  a  percuffion  on  the  head. 

The  connexion  of  the  motions  of  the  ftomach  with  irritative 
ideas,  or  motions  of  the  organs  of  fenfe,  in  vertigo,  is  (hewn  in 
Seel:.  XX.  and  thus  it  appears,  that  many  circles  of  aflbciation 
are  either  directly  or  reverfely  aflbciated,  or  catenated,  with  this 
s ;  which  will  much  contribute  to  unfold  fome  of  the  fymp- 
toii-G  of  fever. 

K.   Tertian  Ajficiations . 

The  third  link  of  aflbciate  trains  of  motion  is  fometimes  actu- 
ated by  reverfe  fympathy,  with  the  fecond  link,  and-  that  by  re- 
verfe fympathy  with  the  firft  link  ;  fo  that  the  firft  and  third  link 
may  aft  by  direct  fympathy,  and  the  intermediate  one  by  re- 
verfe fympathy.  Of  this,  inftances  are  given  in  the  fingultus 
nephriticus,  Ciafs  IV.  i.  i.  7.  and  IV.  2.  r.  At  other  times 
the  tertian  or  quartan  links  of  aflbciate  motions  are  actuated  by 
direct  fympathy  j  and  that  fometimes  forwards  and  fometimes 
backwards  in  refpect  to  the  ufual  order  of  thofe  trains  of  aflbci- 
ate  motions,  as  in  Clafs  IV.  i.  2.  i. 

SPECIES, 

i ,  Rubor  vithiis  pranforum.     Flufhing  of  the  face  after  dinner 


CLASS  IV.  i.  i.  2.      OF  ASSOCIATION,  369 

is  explained  in  Seel.  XXXV.  i.  In  the  beginning  of  intoxica- 
tion the  whole  fldn  becomes  florid  from  the  afTociation  of  the  ac- 
tions of  the  cutaneous  arteries  with  thofe  of  the  ftomach,  be- 
caufc  vinous  fpirit  excites  the  fibres  of  the  ftomach  into  more 
violent  action  than  the  ftimulus  of  common  food  •,  and  the  cu- 
taneous capillaries  of  the  face,  from  their  more  frequent  expo- 
fure  to  the  viciflitudes  of  cold  and  heat,  poflefs  more  mobility  or 
irritability  than  thofe  of  other  parts  of  the  {kin,  as  further  ex- 
plained in  Seel.  XXXIII.  2.  10.  Vinegar  is  liable  to  produce 
this  flufhing  of  the  face,  which  probably  is  owing  to  the  quanti- 
ty of  vinous  fpirit  it  contains,  as  I  believe  the  unfermented  veget- 
able acids  do  not  produce  this  effect.  In  every  kind  of  blufti 
the  arterial  blood  is  propelled  into  the  capillaries  farter  than  the 
venous  abforption  can  carry  it  forwards  into  the  veins,  in  this 
refpect  refembling  the  tenfio  phalli. 

Can  the  beginning  vinous  or  acetous  fermentation  of  the  ali- 
ment in  weak  ftomachs  contribute  to  this  effect  ?  or  is  it  to  be 
afcribed  to  the  greater  power  of  aflbciation  between  the  arteries 
of  the  face  and  the  fibres  of  the  ftomach  in  fome  people  than  in. 
others  ? 

M.  M.  Eat  and  drink  lefs  at  a  time,  and  more  frequently. 
Put  20  drops  of  weak  acid  of  vitriol  into  water  to  be  drunk  at 
meals.  Let  the  drefs  over  the  ftomach  and  bowels  be  loofe. 
Ufe  no  fermented  liquors,  or  vinegar,  or  fpice. 

2.  fudorjlragulu  immerforum.  Sweat  from  being  covered  in 
bed.  In  the  commencement  of  an  epidemic  fever,  in  which  the 
perpetual  efforts  to  vomit  was  a  diftrefling  fymptom,  Dr.  Syd- 
enham  discovered,  that  if  the  patient's  head  was  for  a  (hort  time 
covered  over  with  the  bed-clothes,  warmth  was  produced,  and 
a  fweat  broke  out  upon  the  fkin,  and  the  tendency  to  vomit  ceaf- 
cd.  In  this  curious  fact  two  trains  of  affbciated  motions  are 
excited  into  increafed  action.  Firft,  the  veffrls  of  the  lungs  are 
known  to  have  their  motion  afibciated  with  thofe  of  the  fkin  by 
the  difficulty  of  breathing  on  going  into  the  cold  bath,  as  defcrib- 
ed  in  Se&.  XXXII.  3.  2.  Hence,  when  the  veflels  of  the 
lungs  become  excited  into  (Ironger  action,  by  the  bad  air  under 
the  bed-clothes,  warmed  and  adulterated  by  frequent  breathing, 
thofe  of  the  external  fkin  foon  become  excited  by  their  aflbcia- 
uon  into  more  energetic  action,  and  generate  more  heat  along 
with  a  greater  fecretion  of  perfpirable  matter.  Secondly,  the 
fympathy  between  the  ftomach  and  fkin  is  evident  in  variety  of 
circumftances ;  thus  the  cold  air  of  frofty  days  applied  to  the 
(kin  for  a  fhort  time  increafes  the  action  of  the  ftomach  by  re- 
verfe  fympathy,  but  decreafes  it  if  continued  too  long  by  direct 
fympathy  \  fo  in  the  circumftancc  above  mentioned,  the  action 

VOL.  II.  Z  z  of 


DISEASES  CLASS  IV.  i.  i.  3. 

of  the  ftomach  is  iricreafed  by  direct  fympathy  with  that  of  the 
fk'm  ;  and  the  tendency  to  vomit,  which  was  owing  to  its  di- 
minifhed  action,  ceafes. 

3.  Ceffhtio  tfgrhudlms  cute  excitatd.     The  cure  of  ficknefs  by 
ftimulating  the  fkin.     This  is  explained  in  the  preceding  arti- 
cle ;  and  further  noticed  in  IV.  2.  2.  4.  and  in  IV.  i.  i.  F. 

Similar  to  thefe  is  the  effect  of  a  blifter  on  the  back  in  reliev- 
ing ficknefs,  indigeftion,  and  heart-burn  ;  and,  on  the  contrary, 
by  thefe  fymptoms  being  frequently  induced  by  coldnefs  of  the 
extremities.  The  blifter  ftimulates  the  cutaneous  veffels  into 
greater  action;  whence '  warmth  and  pain  are  produced  at  the 
fame  time,  and  the  fibres  of  the  itomach  are  excited  into  greater 
action  by  their  afTociation  with  thofe  of  the  (kin.  It  does  not 
appear,  that  the  concommitant  pain  of  the  blifter  caufes  the  in- 
creafed  energy  of  the  ftomach,  !becaufe  the  motions  of  it  are  not 
greater  than  natural  j  though  it  is  fometimes  difficult  to  deter- 
mine, whether  the  primary  part  of  fome  afTociated  trains  be 
connected  with  irritative  or  fenfitive  motions. 

In  the  fame  manner  a  flannel  fhirt,  to  one  who  has  not  been 
in  the  habit  of  wearing  one,  ftimulates  the  fkin  by  its  points, 
and  thus  (tops  vomiting  in  fome  cafes  ;  and  is  particularly  effi- 
cacious in  checking  fome  chronical  diarrhoeas,  which  are  not  at- 
tended with  fever  ;  for  the  abforbents  of  the  fkin  are  thus  ftim- 
ulated  into  greater  action,  with  which  thofe  of  the  inteitines 
confent  by  direct  fympathy. 

This  effect  cannot  be  afcribed  to  the  warmth  alone  of  the 
flannel  fhirt,  as  being  a  covering  of  loofe  texture,  and  confining 
air  in  its  pores,  like  a  fponge,  which  air  is  known  to  be  a  bad 
'conductor  of  heat,  fince  in  that  cafe  its  ufe  fhould  be  equally 
efficacious,  if  it  were  worn  over  a  linen  fhirt ;  and  an  increafed 
warmth  of  the  room  of  the  patient  would  be  equally  ferviceable. 

4.  DJgeftto  auftaf rigor e  ctttaneo.     Digeilion  increafed  by  cold- 
nefs  of  the  fkin.     Every  one  has  experienced  the  increafe  of 
3ns  appetite  after  walking  in  the  cool  air  in  frofty  days ;   for 
there  is  at  this  time  not  only  a  faving  of  fenforial  power  by  the 
lefs  exertion  of  the  cutaneous  veflels  ;  but,  as  thefe  confent  with 
thofe  of  the  ftomach  and  bowels,  this  faving  of  fenforial  power 
is  transferred  by  reverfe  fympathy  from  the  cutaneous  capilla- 
ries and  abforbent.s  to  thofe  of  the  ftomach  and  interlines. 

Hence  weak  people  fhould  ufe  the  cold  air  of -winter  as  a  cold 
bath  •,  that  is,  they  fliould  ftay  in  it  but  a  fhort  time  at  once, 
but  fhould  immerfe  themfelves  in  it  many  times  a  day. 

5.  Gatarrhus  a  f rigor e  cutaneo.    Catarrh  from  cold  fkin.    This 
has  been  already  explained  in  Clafs  I.  1.2.  7.  and  is  further 
defcribcd  in  Sed.  XXXV.  1.3,     In  this  difeafe  the  veflels  of 

the 


CLAssIV.  j.  i.  6.      OF  ASSOCIATION.  37; 

the  membrane,  which  lines  the  noftrils,  are  excited  into  greater 
action  ;  when  thofe  of  the  Ikin,  with  which  they  are  aflbciated, 
are  excited  into  lefs  action  by  the  deficiency  of  external  heat, 
by  reverfe  fympathy  ;  and  though  the  pain  of  cpld  attends  the 
torpor  of  the  primary  link  of  this  aflbciation,  yet  the  increafed 
motions  of  the  membrane  of  the  noftrils  are  ailociated  with 
thofe  of  the  cutaneous  veflels,  and  not  with  the  pain  of  them, 
becaufe  no  inflammation  follows. 

6.  Abforptio  cellularls  aufta  vomitu.     In  the  aft  of  vomiting 
the  irritative  motions  of  the  ftomach  are  inverted,  and  of  the 
abforbents,  which  open  their  mouths  into  it ;  while  the  cutane- 
ous, cellular,  and  pulmonary  abforbents  are  induced,  by  reverfe 
fympathy  with  them,  to  a<ft  with  greater  energy.     This  i.s  feen 
in  cafes  of  anafarca,  when  long  ficknefs  and  vomiting  are  cauf- 
ed  by  fquills,  or  antimonial  falts,  or  moil  of  all  by  the  decoction 
of  digitalis  purpurea,  foxglove  5  and  Mr.  J.  Hunter  mentions  a 
cafe,  in  which  a  large  bubo,  which  was  juit  ready  to  break, 
was  abforbed  in  a  few  days  by  ficknefs  at  fea.     Treatife  on  the 
Blood,  p.  501,  which  is  thus  accounted  forj  lefs  fenforial  pow- 
er is  expended  during  ficknefs  by  the  decreafed  action  of  the 
fibres  of  the  ftomach,  and  of  its  abforbents ;  as  (hewn  in  Seel:. 
XXXV.  i.  3.  whence  an  accumulation  of  it  is  produced,  and 
there  is  in  confequence  a  greater  quantity  of  fenforial  power 
for  the  exertion  of  thofe  motions,  which  are  aflbciated  with  the 
abforbents  of  the  ftomach  by  reverfe  fympathy. 

The  reverfe  fympathy  between  the  lacteal  and  lymphatic 
branches  of  the  abforbent  fyftem  have  been  produced  by  the  one 
branch  being  lets  excited  to  act,  when  the  other  fupplies  fuffi- 
cient  fluid  or  nutriment  to  the  fanguiferous  veflels.  Thus  when 
the  ftomach  is  full,  and  the  fupply  of  chyle,  and  mucus,  and 
water  is  in  fufficient  quantity  ;  the  pulmonary,  cellular,  and  cu- 
taneous lymphatics  are  not  excited  into  action  ;  whence  the 
urine  is  pale,  and  the  Ikin  moift,  from  the  defect  of  abfcrption 
on  thofe  furfaces. 

7.  Singultus  nephriticus.     When  a  ftone  irritates  the  ureter, 
and  that  even  without  its  being  attended  with  pain  or  fever, 
fometimes  a  chronical  hiccough  occurs,  and  continues  for  days 
and  weeks,  inftead  of  ficknefs  or  vomiting  •,  which  are  the  com- 
mon fymptoms.     In  this  cafe  the  motions  of  the  ftomach  are 
decreafed  by  their  fympathy  with  thofe  of  the  ureter,  which  are 
increafed  by  the  ftimulus  of  the  ftone  in  it  •,  and  the  increafed 
motions  of  the  diaphragm  feem  to  exift  in  confequence  of  their 
aflbciation  with  the  ftomach  by  a  fecond  reverfe  fympathy.    This 
hiccough  may  nevertheless  admit  of  another  explanation,  and 
be  fuppofed  to  be  a  convulfive  exertion  of  the  diaphragm  to  re- 
lieve 


37*  DISEASES  CLASS  IV.  i.  i.  8. 

licve  the  difagreeable  fenfation  of  the  ftomach  in  confequence 
of  its  difordered  irritative  aflbciations  ;  and  in  that  cafe  it  would 
belong  to  Clafs  III.  i.  i.  See  Clafs  IV.  2.  i.  for  another  ex- 
ample of  tertiary  aflbciation. 

M.  M.  Venefeclion.  Emetic.  Calomel.  Cathartic,  opium, 
oil  of  cinnamonj  from  two  to  ten  drops.  Aerated  alcaline  water. 
Peruvian  bark. 

8.  Febris  irritatha.  Irritative  fever,  defcribed  in  Clafs  I.  i. 
i.  i.  The  difeafes  above  explained  in  this  genus  are  chiefly 
concerning  the  fympathies  of  the  abforbent  fyftem,  or  the  ali- 
mentary canal,  which  are  not  fo  much  afibciated  with  the  arte- 
rial fyflem  as  to  throw  it  into  diforder,  when  they  are  ilightly 
deranged  •,  but  when  any  great  congeries  of  conglomerate  glands, 
which  may  be  confidered  as  the  extremities  of  the  arterial  fyf- 
tem,  are  affected  with  torpor,  the  whole  arterial  fyflem  and  the 
heart  fympathize  with  the  torpid  glands,  and  acl  with  lefs  ener- 
gy ;  which  conftitutes  the  cold  fit  of  fever ;  which  is  therefore 
at  firft  a  decreafed  a£lion  of  the  afibciate  organ ;  but  as  this  de- 
creafe  of  action  is  only  a  temporary  effecl:,  and  an  increafe  of 
exertion  both  of  the  torpid  glands,  and  of  the  whole  arterial 
fyftem,  foon  follows ;  the  hot  fit  of  .irritative  fever,  or  fever 
with  ftrong  pulfe,  properly  belongs  to  this  clafs  and  genus  of 
difeafes. 


ORDO 


CLASS  IV.  i.  2.        OF  ASSOCIATION.  373 

ORDO  I. 

Increafed  Ajficiate  Motions, 

GENUS  II. 
Catenated  with  Senfttive  Motions. 

THE  primary  links  of  the  aflbci  ated  actions  of  this  genus  are 
either  produced  or  attended  by  painful  or  pleafurable  ienfation. 
The  fecondary  links  of  the  firft  ten  fpecies  are  attended  with 
increafcd  motions  without  inflammation,  thofe  of  the  remainder 
are  attended  with  inflammation.  All  inflammations,  which  do 
not  arife  in  the  part  which  was  previoufly  torpid,  belong  to  this 
genus  ;  as  the  gout,  rheumatifm,  eryfipelas.  It  is  probable  many 
other  inflammations  may,  by  future  obfervation,  require  to  be 
tranfplanted  into  this  clafs. 

The  circles  of  fenfitive  afTociate  motions  confift  chiefly  of  the 
excretory  duels  of  the  capillaries  and  of  the  mouths  of  the  ab- 
forbent  veflels,  which  conftitute  the  membranes ;  and  which 
have  been  induced  into  action  at  the  fame  time  ;  or  they  confift 
of  the  terminations  of  canals ;  or  of  parts  which  are  endued 
with  greater  fenfibility  than  thofc  which  form  the  firft  link  of 
the  aflbciation.  An  inftance  of  the  firft  of  thofe  is  the  fympa- 
thy  between  the  membranes  of  the  alveolar  procefles  of  the  jaws, 
and  the  membranes  above  or  beneath  the  mufcles  about  the 
temples  in  hemicrania.  An  inftance  of  the  fecond  is  in  the 
fympathy  between  the  excretory  duel:  of  the  lachrymal  gland,  and 
the  nafal  duel  of  the  lachrymal  fac.  And  an  inftance  of  the 
third  is  the  fympathy  between  the  membranes  of  the  liver,  and 
the  (kin  of  the  face  in  the  gutta  rofea  of  inebriates. 

SPECIES. 

I.  Lachrymarum  fuxus  fympatheticus.  A  flow  of  tears  from 
grief  or  joy.  When  the  termination  of  the  duel  of  the  lachry- 
mal fac  in  the  noftrils  becomes  affeeled  either  by  painful  or 
pleafurable  fenfations,  in  confequence  of  external  ftimulus,  or 
by  its  aflbciation  with  agreeable  or  difagreeable  ideas,  the  mo- 
tions of  the  lachrymal  gland  are  at  the  fame  time  exerted  with 
greater  energy,  and  a  profufion  of  tears  fucceeds  by  fenfitive  af- 
fociation,  as  explained  in  Seel.  XVI.  8.  2. 

In  this  cafe  there  exiits  a  chain  of  affociated  aelions,  the  fe- 
cretion  of  the  lachrymal  gland  is  increafed  by  whatever  ftimu- 

late* 


374  DISEASES  CLASS  IV.  i.  2. 3. 

lates  the  furfacc  of  the  eye,  at  the  fame  time  the  increafed  abun- 
dance of  tears  ftimulates  the  pundta  lachrymalia  into  greater  ac- 
tion ;  and  the  fluid  thus  abforbed  ftimulates  the  lachrymal  fac, 
and  its  nafal  duel:  in  the  nofe  into  greater  action.  In  a  contra- 
ry direction  of  this  ch.^n  of  aflbciation  the  prefent  increafe  of 
action  is  induced.  Firft,  the  nafal  duel:  of  the  lachrymal  fac  is 
excited  into  increafed  action  by  fome  pleafurable  or  painful  idea, 
as  defcribed  in  Seel.  XVI.  8.  2.  2d.  The  puncta  lacrymalia 
or  other  extremity  of  the  lachrymal  fac  fympathizes  with  it  (as 
the  two  ends  of  all  other  canals  fympathize  with  each  other.) 
3d.  With  theie  increafed  motions  of  the  puncta  lacrymalia  thofe 
of  the  excretory  duel:  of  the  lachrymal  gland  are  aflbciated  from 
their  having  fo  perpetually  acted  together.  And,  laftly,  with 
the  increafed  actions  of  the  excretory  duel:  of  this  gland  are  af- 
ibciated  thofe  of  the  other  end  of  it  by  their  frequently  acting 
together ;  in  the  fame  manner  as  the  extremities  of  other  ca- 
nals are  aflbciated,  and  thus  a  greater  flow  of  tears  is  poured  in- 
to the  eye. 

When  a  flow  of  tears  is  produced  in  grief,  it  is  believed  to 
relieve  the  violence  of  it,  which  is  worthy  a  further  inquiry. 
Painful  fenfations,  when  great,  excite  the  faculty  of  volition  ; 
and  the  perfon  continues  voluntarily  to  call  up  or  perform  thofe 
ideas,  which  occafion  the  painful  fenfation  ;  that  is,  the  afflict- 
ed perfon  becomes  fo  far  infane  or  melancholy  ;  but  tears  are 
produced  by  the  fenforial  faculty  of  aflbciation,  and  fhew  that 
the  pain  is  fo  far  relieved  as  not  to  excite  the  exceffive  power  of 
volition,  or  infanity,  and  are  therefore  a  fign  of  the  abatement  of 
the  painful  (late  of  grief,  rather  than  a  caufe  of  that  abatement. 
SeeClafsIII.  I.  2.  10. 

2.  Sternutatio  a  lumine.     Some  perfons  fneeze  from  looking 
up  at  the  light  Iky  in  a  morning  after  coming  out  of  a  dark 
bed  room.     The  olfactory  nerves  are  brought  into  too  great  ac- 
tion by  their  fympathy  with  the  optic  nerves,  or  by  their  refpec- 
tive  fympathies  with  fome  intervening  parts,  as   probably  with 
the  two  extremities  of  the  lachrymal  fac  ;  that  is,  with  the  punc- 
ta  lacrymalia  and  the  nafal  duet.     See  Clafs  II.  I.  i.  3. 

3.  Dolor  dcntium  aftrichre.     Tooth-edge  from  grating  founds, 
and  from  the   touch  of  certain  fubftances,  and  even  from  im- 
agination  alone,  is  defcribed  and  explained  in  Sect.  XVI.  10. 
The  increafed  actions  of  the  alveolar  veflels  or  membranes  are 
aflbciated  with  the  ideas,  or  fenfual   motions  of  the  auditory 
nerves  in  the  firft  cafe  •,  and  of  thofe  of  the   fenfe  of  touch,  in 
the  fecond  cafe  j  and  by  imagination,  or  ideas  exerted  of  painful 
fenfation  alone,  in  the  laft. 

Rifusfardonicus*     A  difagreeable  fmile  attends  inflammations 

of 


CLASS  IV.  i.  a,  5.     OF  ASSOCIATION.  375 

of  the  diaphragm  arifing  from  the  aflbciations  of  the  reiterated 
exertions  of  that  mufcle  with  thofe  of  the  lips  and  cheeks  in 
laughing.  See  Diaphra^mitis,  Clafs  II.  i.  2.  6. 

5.  Saliva  fuxits  cibo  vifo.     The  flow  of  ialiva  into  the  mouths 
of  hungry  animals  at  the  fight  or  fmell  of  food  is   feen  in  dogs 
{landing   round  a  dinner-table.     The  increafed  actions  of  the 
falivary  glands  have  been  ufually  produced  by  the  ftimulus  of 
agreeable  food  on  their  excretory  duels  during  the  maftication 
of  it  •,  and  with  this  increafed  attion  of  their  excretory  duftsthe 
other  terminations  of  thofe  glands  in   the  capillary  arteries  have 
been  excited  into  increafed  action  by  the  mutual  aflbciation  of 
the  ends  of  canals  ;  and  at  the  fame  time  the  pleafurable  ideas, 
or  fenfual  motions,  of  the  fenfe  of  fmell  and  of  fight  have  accom- 
panied this  increafed  fecretion  of  faliva.     Hence  this  chain  of 
motions  becomes  aflbciated  with  thofe  vifual  or  olfactory  ideas, 
or  with  the  pleafure,  which  produces  or  attends  them. 

6.  Tenfw  mammularum  vifo  puerulo.    The  nipples  of  la£tefcent 
women  are  liable  to  become   turgid  at  the  fight  of  their  young 
offspring.     The  nipple  has  generally  been  rendered  turgid  by 
the  titillation  of  the  lips  or  gums  of  the  child  in  giving  fuck  ; 
the  vifible  idea  of  the  child  has  thus  frequently   accompanied 
this  pleafurable  fenfation  of  parting  with  the  milk,  and  turgef- 
cence  of  the   tubes,    which  conflitute  the  nipple.     Hence  the 
vifual  idea  of 'the  child,  and  the  pleafure  which  attends    it,  be- 
come  afibciated  with  thofe  increafed   arterial   actions,  which 
fwell  the  cells  of  the  mammula,  and  extend  its  tubes ;  which  is 
very  fimilar  to  the  tenfio  phalli  vifa  muliere  nuda  etiam  in  in- 
fomnio. 

7.  Tenfio  perns  in  hydrophobia.     An  erection  of  the  penis  oc- 
curs in  the  hydrophobia,  and  is  a  troublefome  iymptom,  as  ob- 
ferved  by  Ccelius   Aurelianus,  Fothergill,  and  Vaughan,   and 
would  feem  to  be  produced  by  an  unexplained  fympathy  between 
the  fenfations  about  the  fauces  and  the  penis.     In  men  the  hair 
grows  about  both  thefe  parts,  the  voice  changes,  and  the  neck 
thickens  at  puberty.     In  the  mumps,  when  the  fwellings  about 
the  throat  fubfide,  the  tefticles  are  liable  to  fwell.     Venereal  in- 
fection received  by  the  penis    is  very  fcable  to  affect  the  throat 
with  ulcers.     Violent  coughs,   with  forenefs  or  rawneis  about 
the  fauces  are  often  attended  with  erection  of  the  penis  ;  which 
is  alfo  laid  to  happen  to  male  animals,  that  are  hanged  -3  which 
laft  circumftance  has  generally  been  afcribed  to  the  obttruclion 
of  the  circulation  of  the  blood,  but  is  more  probably  occaGoned 
by  the  ftimulus  of  the  cord  in   comprefling  the  throat ;  fince   if 
it  was  owing  to  impeded  circulation  it  ought  equally  to  occur  in 
browning  animals. 

In 


376  DISEASES  CLASS  IV.  i.  2.  S. 

In  men  the  throat  becomes  fo  thickened  at  the  time  of  puber- 
ty, that  a  meafure  of  this  is  ufed  to  afcertain  the  payment  of  a 
poll-tax  on  males  in  fome  of  the  iflands  of  the  Mediterranean, 
which  commences  at  puberty  •,  a  firing  is  wrapped  twice  round 
the  thinneft  part  of  the  neck,  the  ends  of  it  are  then  put  into 
each  corner  of  the  mouth ;  and  if,  when  thus  held  in  the  teeth, 
it  pafles  readily  over  the  head,  the  fubjecl:  is  taxable. 

It  is  difficult  to  point  out  by  what  circumftance  the  fenfitive 
motions  of  the  penis  and  of  the  throat  and  nofe  become  aflbci- 
ated  ;  I  can  only  obferve,  that  thefe  parts  are  fubjecled  to  great- 
er pleafurable  fenfatkms  than  any  other  parts  of  the  body  j  one 
being  defigned  to  preferve  ourfelves  by  the  pleafure  attending 
the  fmell  and  deglutition  of  food,  and  the  other  to  enfure  the 
propagation  of  our  fpecies  :  and  may  thus  gain  an  aflbciation  of 
their  fenfitive  motions  by  their  being  eminently  fenfible  to  pleaf- 
ure. SeeClafsI.  3.  i.  u.  and  III.  i.  i.  15.  andSeft.  XVI. 
5.  See  Gonorrhoea  venerea,  II.  i.  5.  i. 

In  the  female  fex  this  aflbciation  between  the  face,  throat, 
nofe,  and  pubis,  does  not  exift  ;  whence  no  hair  grows  on  their- 
chins  at  the  time  of  puberty,  nor  do  their  voices  change,  or  their 
necks  thicken.  This  happens  probably  from  there  being  in  them 
a  more  exquifite  fenifitve  fympathy  between  the  pubis  and  the 
breads.  Hence  their  breafts  fwell  at  the  time  of  puberty,  and 
fecrete  milk  at  the  time  of  parturition.  And  in  the  parotitis,  or 
mumps,  the  breafts  of  women  fwell,  when  the  tumor  of  the  pa- 
rotitis fubfides.  SeeClafsI.  i.  2.  15.  Whence  it  would  ap- 
pear, that  their  breafts  poiTefs  an  intermediate  fympathy  between 
the  pubis  and  the  throat ;  as  they  are  the  feat  of  a  paflion,  which 
men  do  not  poiTefs,  that  of  fuckling  children. 

8.  Tenefmus  calctilofus.    The  fphincler  of  the  rectum  becomes 
painful  or  inflamed  from  the  aflbciation  of  its  fenfitive  motions 
with  thofe  of  the  fphincler  of  the  bladder,  when  the  latter  is 
(timulated  into  violent  pain  or  inflammation  by  a  (tone. 

9.  Polypus  narium  ex  afcandibus  ?     The  ftirnulation  of  afcari- 
des  in  the  reclum  produces,  by  fenfitive  fympathy,  an  itching  of 
the  nofe,  as  explained  in  IV.  2.   2.  6 ;  and  in  three  children  I 
have    feen    a  polypus    in  the   nofe,   who    were  all     affected 
with   afcarides  ;   to  the   perpetual   ftimulation   of  which,  and 
the  confequent  fenfitive  aflbciation,    I  was  led  to  afcribe   the 
inflammation  and  thickening  of  the  membrane  of  the  noftrils. 

10.  Crampus  fur  arum  in  cholera.  A  cramp  of  the  mufcles  of 
the  legs  occurs  in  violent  diarrhoea,  or  cholera,  and  from  the 
ufe  of  too  much  acid  diet  in  gouty  habits.  This  ieems  to  fym» 
pathize  with  uneafy  fenfation  in  the  bowels.  See  Clafs  III.  i. 
i.  14,  This  aflbciation  is  not  eafiiv  accounted  for,  but  is  anal- 
ogous 


CLASS  IV.  i .  2.  1 1 .      OF  ASSOCIATION.  3  7  7 

ogous  in  fome  degree  to  the  paralyfis  of  the  mufcles  of  the  arms 
in  colica  faturnina.  It  would  feem,  that  the  mufcles  of  the  legs 
in  walking  get  a  fympathy  with  the  lower  parts  of  the  inteftines* 
and  thofe  of  the  arms  in  variety  of  employment  obtain  a  fympa- 
thy with  the  higher  parts  of  them.  See  Cholera  and  Ileus. 

1 1 .  Zona  ignea   nephritica.     Nephritic  {hingles.     The  exter- 
nal fkin  about  the  loins  and  fides  of  the  belly  I  fuppofe  to  have 
greater  mobility  in  refped~l  to  fenfitive  aflbciation,  than  the  ex- 
ternal membrane  of  the  kidney;   and  that  their  motions  are  by 
fome  unknown  means  thus  aflociated.     When  the  torpor  or  be- 
ginning inflammation  of  this  membrane  ccafes,  the  external  fkin 
becomes  inflamed  in  its  (lead,  and  a  kind   of  herpes,  called  the 
fhingles,  covers  the  loins  and  fides  of  the  belly.     See  Clafs  II. 
i.  5.9. 

12.  Eruptio  variolarum.     After  the  inflammation  of  the  in- 
oculated arm  has  fpread  for  a  quarter  of  a  lunation,  it  affects  the 
ftomach  by  reverfe  fympathy  ;  that  is,  the  actions  of  the  Horn- 
ach  are  affociated  with  thofe  of  the  (kin  ;  and  as  much  fenfori- 
al  power  is  now  exerted  on  the  inflamed  fkin,  the  other  part  of 
this  fenfitive  afTociatkm  is  deprived  of  its  natural  fliare,  and  be- 
comes torpid,  or  inverts  its  motions.     After  this  torpor  of  the 
ftomach  has  continued  a  time,  and  much  fenforial  power  is  thus 
accumulated;  other  parts  of  the  fkin,  which  are  alfo  affociated. 
\vith  it,  as  that  of  the  face   firft,   are  thrown   into  partial  in- 
flammation ;  that  is  the  eruptions  of  the  fmall-pox  appear  on 
the  face. 

For  that  the  variolus  matter  affecls  the  ftomach  previous  to 
its  eruption  on  the  fkin,  appears  from  the  ficknefs  at  the  com- 
mencement of  the  fever  ;  and  becaufe,  when  the  morbid  motions 
affecl  the  fkin,  thofe  of  the  ftomach  ceafe  ;  as  in  the  gout  and 
eryfipelas,  mentioned  below.  The  confent  between  the  ftom- 
ach and  the  fkin  appears  in  variety  of  other  difeafes ;  and  as 
they  both  confift  of  furfaces,  which  abforb  and  fecrete  a  quanti- 
ty of  moifture,  their  motions  muft  frequently  be  produced  to- 
gether, or  in  fucceflion  ;  which  is  the  foundation  of  all  the  fym- 
pathies  of  animal  motions,  whether  of  the  irritative,  fenfitive,  or 
voluntary  kinds. 

Now  as  the  fkin,  which  covers  the  face,  is  expofed  to  greater 
variations  of  heat  and  cold  than  any  other  part  of  the  body  ;  it 
probably  poflefies  more  mobility  to  fenfitive  aflbciations,  not  on- 
ly than  the  ftomach,  but  than  any  other  part  of  the  fkin  ;  and 
is  thence  affe&ed  at  the  eruption  of  the  fmall-pox  with  violent 
action  and  confequent  inflammation,  by  the  aflbciation  of  its  mo- 
tions with  thofe  of  the  ftomach,  a  day  before  the  other  parts  of 

VOL.  II.  A  A  a  the 


3  7  8  DISEASES  CLASS  IV.  i .  2. 1 3, 

the  {kin  ;  and  becomes  fuller  of  puftules,  than  any  other  part  of 
the  body.     See  Clafs  II.  i.  3.  9. 

It  might  be  fuppofed,  that  the  fucceflive  fwelling  of  the  hands, 
when  the  face  fubfides,  at  the  height  of  the  fmall-pox,  and  of 
the  feet,  when  the  hands  fubfide,  were  governed  by  fome  un- 
known afibciations  of  thofe  parts  of  the  fyftem  ;  but  thefe  fuc- 
ceflions  of  tumor  and  fubfidence  more  evidently  depend  on  the 
times  of  the  eruption  of  the  puftules  on  thofe  parts,  as  they  appear 
a  day  fooner  on  the  face  than  on  the  hands,  and  a  day  fooner 
on  the  hands  than  on  the  feet,  owing  to  the  greater  comparative 
mobility  of  thofe  parts  of  the  fkin. 

13.  Gutta  rofea  Jlomatlca.     Stomatic  red  face.     On  drinking 
cold  water,  or  cold  milk,  when  heated  with  exercife,   or  on  eat- 
ing cold  vegetables,  as  raw  turnips,  many  people  in  harveft-time 
have  been  afflicted  with  what  has  been  called  a   furfeit.     The 
ftomach  becomes  painful,  with  indigeftion  and  flatulency,  and 
after  a  few  days  an  eruption  of  the  face  appears,  and*  continues 
with  fome  relief,  but  not  with  entire  relief;  as  both  the  pimpled 
face  and  indigeftion  are  liable  to  continue  even  to  old  age. 

M.  M.  Venefeclion.  A  cathartic  with  calomel.  Then  half 
a  grain  of  opium  twice  a  day  for  many  weeks.  If  faturated  fo- 
lution  of  arfenic  three  or  five  drops  twice  or  thrice  a  day  for  a 
week  ? 

1 4.  Gutta  rofea  hepatica.     The  rofy  drop  of  the  face  of  fome 
drinking  people  is  produced  like  the  gout  defcribed    below,   in 
confequence  of  an  inflamed  liver.     In  thefe  conftitutions  the 
jkin  of  the  face  being  expofed  to  greater  variation  of  heat  and 
cold  than  the  membranes  of  the   liver,  poffefles  more  mobility 
than  thofe  hepatic  membranes ;   and  hence   by  whatever  means 
thefe  membranes  are  induced  to  fympathize,  when  this  fenfitive 
afibciation  occurs,   the  cutaneous  veflels  of  the  face  run  into 
greater  degrees  of  thofe  motions,  which  conftitute  inflammation, 
than  previoufly  exifted  in  the  membranes  of  the  liver  ;  and  then 
thofe  motions  of  the  liver  ceafe.     See  Clafs  II.   i.  4.  6. 

As  inflammation  of  the  liver  fo  frequently  attends  the  great 
potation  of  vinous  fpirit,  there  is  reafon  to  fufpecl:,  that  this  vif- 
cus  itfelf  becomes  inflamed  by  fenfitive  afibciation  with  the 
ftomach  ;  or  that,  when  one  termination  of  the  bile-du6l,  which 
enters  the  duodenum,  is  ftimulated  violently,  the  other  end  may 
become  inflamed  by  fenfitive  afibciation. 

15.  Podagra.     The  gout,  except  when  it  affects  the  liver  or 
ftomach,  feems  always  to  be  a  fecondary  difeafe,  and,  like  the 
rheumatifm  and  eryfipelas  mentioned  below,   begins  with  the 
torpor  of  fome  diftant  part  of  the  fyftem. 

The  moft  frequent  primary  feat  0f  the  gout  I  fuppofe  to  be 


CLASS  IV.  i .  2. 1 5.     OF  ASSOCIATION.  3  79 

the  liver,  which  is  probably  affected  with  torpor  not  only  previ- 
ous to  the  annual  paroxyfms  of  the  gout,  but  to  every  change 
of  its  fituation  from  one  limb  to  another.  The  reafons,  which 
induce  me  to  fufpeft  the  liver  to  be  firft  affedted,  are  not  only 
becaufe  the  jaundice  fometimes  attends  the  commencement  of 
gout,  as  defcribed  in  Seel:.  XXIV.  2.  8.  but  a  pain  alfo  over  the 
pit  of  the  ftomach,  which  I  fuppofe  to  be  of  the  termination  of 
the  bile-duel:  in  the  duodenum,  and  which  is  erroneouily  fup- 
pofed  to  be  the  gout  of  the  ftomach,  with  indigeftion  and  flatu- 
lency, generally  attends  the  commencement  of  the  inflamma- 
tion of  each  limb.  See  Arthritis  ventriculi,  Clafs  I.  2.  4.  6. 
In  the  two  cafes,  which  I  faw,  of  the  gout  in  the  limbs  being 
preceded  by  jaundice,  there  was  a  cold  fhivering  fit  attended  the 
inflammation  of  the  foot,  and  a  pain  at  the  pit  of  the  ftom- 
ach;  which  ceafed  along  with  the  jaundice,  as  foon  as  the 
foot  became  inflamed.  This  led  me  to  fufpect,  that  there  was  a 
torpor  of  the  liver,  and  perhaps  of  the  foot  alfo,  but  neverthe- 
lefs  the  liver  might  alfo  in  this  cafe  be  previoufly  inflamed,  as 
obferved  in  Sett.  XXIV.  2.  3. 

Now  as  the  membranes  of  the  joints  of  the  feet  fuffer  greater 
variations  of  heat  and  cold  than  the  membranes  of  the  liver,  and 
are  more  habituated  to  extenfion  and  contraction  than  other 
parts  of  the  fkin  in  their  vicinity ;  I  fuppofe  them  to  be  more 
mobile,  that  is,  more  liable  to  run  into  extremes  of  exertion  or 
quiefcence  ;  and  are  thence  more  fufceptible  of  inflammation, 
than  fuch  parts  as  are  lefs  expofed  to  great  variations  of  heat 
and  cold,  or  of  extenfion  and  contraction. 

When  a  ftone  preffes  into  the  fphineler  of  the  bladder,  the 
glans  penis  is  affected  with  greater  pain  by  fympathy,  owing  to 
its  greater  fenfibility,  than  the  fphineler  of  the  bladder  ;  and  > 
when  this  pain  commences,  that  of  the  fphindler  ceafes,  when 
the  ftone  is  not  too  large,  or  pufhed  too  far  into  the  urethra. 
Thus  when  the  membrane,  which  covers  the  ball  of  the  great 
toe,  fympathizes  with  fome  membranous  part  of  a  torpid  or  in- 
flamed liver  ;  this  membrane  of  the  toe  falls  into  that  kind  of 
action,  whether  of  torpor  or  inflammation,  with  greater  energy, 
than  thofe  actions  excited  in  the  difeafed  liver ;  and  when  this 
new  torpor  or  inflammation  commences,  that  with  which  it  fym- 
pathizes ceafes ;  which  I  believe  to  be  a  general  law  of  aflbciat- 
ed  inflammations. 

The  paroxyfms  of  the  gout  would  feem  to  be  catenated  with 
folar  influence,  both  in  relpect  to  their  larger  annual  periods, 
and  to  their  diurnal  periods— See  Se£t.  XXXVI.  3.  6.— -as  the 
former  occur  about  the  fame  feafon  of  the  year,  and  the  latter 
commence  about  an  hour  before  fun-rife  5  neverthclefs  the  an- 
nual 


380  DISEASES          CLASS  IV.  i.  2.  15. 

nual  periods  may  depend  on  the  fucceflion  of  great  viciflitudes 
of  cold  and  heat,  and  the  diurnal  ones  on  our  increafed  fenfibili- 
ty  to  internal  fenfations  during  fleep,  as  in  the  fits  of  afthma, 
and  of  fome  epilepfies.  See  Sect.  XVIII.  15. 

In  reipect  to  the  pre-remote  caufe  or  difpofition  to  the  goutj 
there  can  be  no  doubt  of  its  individually  arifing  from  the  pota- 
tion of  fermented  or  fpirituous  liquors  in  this  country ;  wheth- 
er opium  produces  the  fame  effect  in  the  countries,  where  it  is, 
in  daily  ufe,  I  have  never  been  well  informed.  See  Seel:.  XXI. 
jo.  where  this  fubject  is  treated  of  ;  to  which  I  have  to  add, 
that  I  have  feen  fome,  and  heard  of  others,  who  have  moderat- 
ed their  paroxyfms  of  gout,  by  diminifhing  the  quantity  of  fer- 
mented liquors,  which  they  had  been  accuftomed  to  ;  and  oth- 
ers who,  by  a  total  abftinence  from  fermented  liquors,  have  en- 
tirely freed  themfelves  from  this  excruciating  malady  ;  which 
otherwife.  grows  with  our  years,  and  curtails  or  renders  mifera- 
ble  the  latter  half,  or  third,  of  the  lives  of  thofe,  who  are  fub- 
ject to  it.  The  remote  caufe  is  whatever  induces  temporary 
torpor  or  weaknefs  of  the  fyftem  5  and  the  proximate  caufe  is 
the  inirritability,  or  defective  irritation,  of  fome  part  of  the  fyf- 
tem $  xvhence  torpor  and  confequent  inflammation.  The  great 
Sydenham  faw  the  beneficial  effects  of  the  abftinence  from  fer- 
mented liquors  in  preventing  the  gout,  and  adds,  "  if  an  empiric 
"  could  give  fmall-beer  only  to  gouty  patients  as  a  noftrum,  and 
«  periuade  them  not  to  drink  any  other  fpirituous  fluids,  he 
«  might  refcue  thoufands  from  this  difeafe,  and  acquire  a  for- 
"  tune  for  his  ingenuity."  Yet  it  is  to  be  lamented,  that  this 
accurate  obierver  of  difeafes  had  not  refolution  to  practife  his  own 

fc  iptiun,  and  thus  to  have  fet  an  example  to  the  world  of 
e  truth  cf  his  doctrine ;  but,  on  the  contrary,  recommended 

deira,  the  itrongeil  wine  in  common  ufe,  to  be  taken  in  the 
ts  of  the  gout,  to  the  detriment  of  thoufands ;  and  is  faid  him- 
felf  to  have  perilhed  a  martyr  to  the  diieaie,  which  he  knew 
how  to  fubdue  ! 

As  example  has  more  forcible  effect  than  fimple  affertion,  I 
{hall  now  concifeiy  relate  my  own  cafe,  and  that  of  one  of  my 
moft  reipected  friends.  E.  D.  was  about  forty  years  of  age, 
when  he  was  firit  feized  with  a  fit  of  the  gout.  The  ball  of  his 
right  great  toe  was  very  painful,  and  much  fwelled  and  inflam- 
ed, which  continued  five  or  fix  days  in  fpite  of  venefection,  a 
a  brifk  cathartic  with  ten  grains  of  calomel,  and  the  application 
of  cold  air  and  cold  water  to  his  foot.  He  then  ceafed  to  drink 
ale  or  wine  alone  ;  confining  himfelf  to  fmall-beer,  or  wine  di- 
luted with  about  thrice  its  quantity  of  water.  In  about  a  year 
he  fuffered  two  other  fits  of  the  gout,  in  lefs  violent  degree.  He 

then 


CLASS  IV.  1.2.15.     OF  ASSOCIATION.  3  8 1 

then  totally  abftained  from  all  fermented  liquors,  not  even  tail- 
ing fmall-beer,  or  a  drop  of  any  kind  of  wine  ;  but  ate  plenti- 
fully of  flem-meat,  and  all  kinds  of  vegetables,  and  fruit,  ufmg 
for  his  drink  at  meals  chiefly  water  alone,  or  lemonade,  or  cream 
water ;  with  tea  and  coffee  between  them  as  ufual. 

By  this  abftinence  from  fermented  liquors  he  kept  quite  free 
from  the  gout  for  fifteen  or  fixteen  years  ;  and  then  began  to 
take  fmall-beer  mixed  with  water  occafionally,  or  wine  and 
water,  or  perry  and  water,  or  cyder  and  water  ;  by  which  in- 
dulgence after  a  few  months  he  had  again  a  paroxyfm  of  gout, 
which  continued  about  three  days  in  the  ball  of  his  toe  ;  which 
occafioned  him  to  return  to  his  habit  of  drinking  water,  and  he 
has  now  for  above  twenty  years  kept  in  perpetual  health,  ex- 
cept accidental  colds  from  the  changes  of  the  feafons.  Before 
he  abftained  from  fermented  or  fpirituous  liquors,  he  was  fre- 
quently fubject  to  the  piles,  and  to  the  gravel,  neither  of  which 
he  has  fmce  experienced. 

In  the  following  cafe  the  gout  was  eftabliftied  by  longer  habit 
and  greater  violence,  and  therefore  required  more  cautious  treat- 
ment. The  Rev.  R.  W.  was  feized  with  the  gout  about  the  age 
of  thirty-two,  which  increafed  fo  rapidly  that  at  the  age  of  for- 
ty-one he  was  confined  to  his  room  leven  months  in  that  year ; 
he  had  fome  degree  of  lameneis  during  the  intervals,  with 
chalky  fwellings  of  his  heels  and  elbows.  As  the  difeafe  had 
continued  fo  long  and  fo  violently,  and  the  powers  of  his  d'gef- 
tion  were  fomewhat  weakened,  he  was  advifed  not  entirely  to 
leave  off  all  fermented  liquors  ;  and  as  fmall-beer  is  of  fuch  va- 
rious itrength,  he  was  advifed  to  drink  exactly  two  wine-glafles, 
about  four  ounces,  of  wine  mixed  with  three  or  four  times  its 
quantity  of  water,  with  or  without  lemon  and  fugar,  for  his  dai- 
ly potation  at  dinner,  and  no  other  fermented  liquor  of  any 
kind  ;  and  was  advifed  to  eat  flem-meat  with  any  kind  of  boil- 
ed vegetables,  and  fruit,  with  or  without  fpice.  He  has  now 
fcrupuloufly  continued  this  regimen  for  above  five  years,  and 
has  had  an  annual  moderate  gouty  paroxyfm  of  a  few  weeks, 
inftead  of  the  confinement  of  fo  many  months,  with  great  health 
and  good  fpirits  during  the  intervals. 

The  following  is  a  more  particular  account  of  the  hiftory  of 
this  cafe  ;  being  part  of  a  letter  which  Mr.  Wilmot  wrote  on 
that  fubjecl  at  my  entreaty. 

"  I  entered  into  the  army  with  an  excellent  contlitution  at 
the  age  of  fifteen.  The  corps  I  ferved  in  was  diftinguifhed  by- 
its  regularity,  that  is,  the  regular  allowance  of  the  meis  was  on- 
ly one  pint  of  wine  per  man  each  day  •,  unlefs  we  had  company 
to  dine  with  us  ;  then,  as  was  the  general  cuftom  of  the  time, 

the 


382  DISEASES  CLASS  IV.  i.  2. 15. 

the  bottle  circulated  without  limit.  This  mode  of  living, 
though  by  no  means  confidered  as  excefs  for  men,  was  certainly 
too  great  for  a  youth  of  my  age.  This  ftyle  of  living  I  contin- 
ued, when  with  the  regiment,  till  the  latter  end  of  the  year 
1769,  when  I  had  the  misfortune  to  fleep  in  a  damp  bed  at 
Sheffield  on  a  journey  to  York,  but  arrived  there  before  I  felt 
the  ill  effects  of  it.  I  was  then  feized  with  a  violent  inflamma- 
tory rheumatifm  with  great  inflammation  of  my  eyes,  and  was 
attended  by  Dr.  Dealtry ;  fo  violent  was  the  diforder,  that  I  was 
bled  for  it  eight  times  in  lefs  than  a  fortnight  5  and  was  three 
months,  before  I  could  confider  my  health  perfectly  reeftablifh- 
ed.  Dr.  Dealtry  told  me,  that  I  mould  be  fubject  to  fimilar  at- 
tacks for  many  years  ;  and  that  he  had  no  doubt,  from  the  ten- 
dency he  found  in  my  habit  to  inflammation,  that,  when  I  was 
farther  advanced  in  life,  I  fhould  change  that  complaint  for  the 
gout.  He  predicted  truly  ;  for  the  three  fucceeding  winters  I 
had  the  fame  complaint,  but  not  fo  violently ;  the  fourth  winter 
I  efcaped,  and  imputed  my  efcape  to  the  continuance  of  cold 
bathing  during  the  whole  of  that  winter ;  after  that  I  never 
efcaped  it,  till  I  had  a  regular  and  fevere  fit  of  the  gout :  after 
the  firft  attack  of  rheumatic  fever  I  was  more  abitemious  in  my 
manner  of  living,  though  when  in  company  I  never  fubjected 
myfelf  to  any  great  reftraint.  In  the  year  1774  I  had  quitted 
the  army,  and  being  in  a  more  retired  fituation,  was  feldom  led 
into  any  excefs ;  in  1 776  and  1777!  was  in  the  habit  of  drink- 
ing a  good  deal  of  wine  very  frequently,  though  not  conftantly. 
After  that  period  till  the  year  1781, 1  drank  a  larger  quantity  of 
wine  regularly,  but  very  feldom  to  any  degree  of  intoxication. 
I  lived  much  at  that  time  in  the  fociety  of  fome  gentlemen,  who 
ufually  drank  nearly  a  bottle  of  wine  daily  after  dinner.  I  mull 
here  however  obferve,  that  at  no  part  of  my  life  was  I  accuftom- 
ed  to  drink  wine  in  an  evening,  and  very  feldom  drank  any 
thing  more  than  a  (ingle  half-pint  glafs  of  fome  fort  of  fpirits 
diluted  with  much  water.  Till  the  year  1781  I  had  always 
been  aceuilomed  to  ufe  very  violent  and  continued  exercife  on 
horfe-back  •,  in  the  winter  months  I  purfued  all  field  diverfions, 
and  in  the  fummer  months  I  rode  frequent  and  long  journeys ; 
and  with  this  exercife  was  liable  to  perfpire  to  great  excefs  ;  be- 
tides which  I  was  fubjecl:  to  very  profuie  night-fweats,  and  had 
frequently  boils  break  out  all  over  me,  efpecially  in  the  fpring 
and  autumn  ;  for  which  I  took  no  medicine,  except  a  little  of 
the  flowers  of  fulphur  with  cream  of  tartar  in  honey. 

"  You  will  obferve  I  bring  every  thing  down  to  the  date  of 
1781.     In  the  month  of  October  in  that  year,  when  I  was  juft 
-entered  into  the  thirty-fecond  year  of  my  age,  I  had  the  firft  at- 
tack 


CLASS IV.  i.  2. 15.      OF  ASSOCIATION. 

tack  of  gout ;  that  fit  was  very  fevere,  and  of  many  weeks  con- 
tinuance.    I  now  determined  upon  a  more  abftemious  method 
of  living,  in  refpedl  to  wine  ;  and  indeed  the  fociety,  in  which 
I  had  before  been  accuftomed  to  live,  being  confiderably  chang- 
ed, I  had  lefs  frequent  temptations  to  excefs.     From  this  time  I 
enjoyed  the  moft  perfect  good  date  of  health  till  Auguft  1784, 
when  I  had  my  fecond  attack  of  gout.     I  never  perfectly  recov- 
ered from  this  attack  through  the  fucceeding  winter,  and  in 
March  1785,  was  advifed  to  try  the  Bath  waters,  and  drank 
them  under  the  direction  of  one  of  the  faculty  of  that  place. 
I  was  there  foon  feized  with  a  fever,  and  a  flight  attack  of  gout 
in  one  knee.     I  fhould  obferve,  that  when  I  fet  out  from  home, 
I  was  in  a  weak  and  low  ftate,  and  unequal  to  much  fatigue ;  as 
appeared  by  my  having  a  fainting  fit  one  day  on  the  road,  after 
having  travelled  only  about  fifty  miles  ;   in  the  courfe  of  the 
fummer  I  had  two  or  three  more  flight  attacks  of   eout  of  lefs 
confequence,  till  the  month  of  October  ;  when  I  was  afflicted 
with  it  all  over  me  in  fuch  a  manner,  as  to  be  without  the  pof- 
fibility  of  the  lead   degree  of  removal  for  fome  days  ;   and  was 
about  two  months  without  being  able  to  get  into  the  air.     This 
was  the  fevereft  attack  I  had  then  experienced ;  though  I  have 
fmce  had  feveral  equally  fevere.     In  the  courfe  of  this  fummer 
1  had  a  fall  with  my  horfe  5  and  foon  after  it,  having  difcovered 
an  enlargement  on  one  elbow,  I  concluded  I  had  hurt  it  at  that 
time  ;  but  in  the  courfe  of  this  laft  attack  having  a  fimilar  en- 
largement on    the  other  elbow,  I  found   my  miftake,  and  that 
they  were  collections  of  gouty  matter ;   thefe  increafed  to  the 
fize  of  pullet's  eggs,  and  continue  in  that  ftate.     I  had  foon  af- 
ter fimihr  enlargements  on  my  heels  ;   the  right  heel  being  fe- 
verely  bruifed,  I  was  under  the  neceflity  of  having  it  lanced,  and 
a  large  quantity  of  chalky   matter  was  difcharged  from  it ;  and 
have  fmce   that  time  frequently  had  chalky  matter  taken  from 
it,  and  fometimes  fmall  bits  of  apparently  perfect   chalk.     My 
right  hand  was  foon  afHidled  in  the  fame  way,  and  I  have  fcarce- 
ly  a  joint  on  thofe  fingers  now  in  a  natural  ftate.    My  left  hand 
has  efcaped  tolerably  well.     After  this  laft  attack  (viz.  October 
1 785),  I  had  two  or  three  flight  attacks  before  the  month  of  June 
1787,  when  I  had  a  very  fevere  intermittent  fever;  from  that 
time  I  continued  very  well  till  the  latter  end  of  the  year,  when  I 
began  to  feel  the  gout  about  me  very  much,  but  was  not  con  fin- 
ed by  it.     I  was  in  this  ftate    advifed  to  try  what  is  called  the 
American  Recipe  (gum  guaiacum  and  nitre  difiblved  in  fpirits) ; 
it  had  apparently  been  of  cflential  fervice  to  a  friend  of  mine, 
who  from  the  inability  to  walk  a  mile  for  fome   years,   was  be- 
lieved to  be  reflored  hv  the  \if.-  of  this  medicine  to  a  good  (late 

of 


384  DISEASES          CLASS  IV.  i.  2.  i$. 

of  health,  fo  as  to  xvalk  ten  miles  a  day.  In  addition  to  this 
medicine  I  drank,  as  my  common  beverage  with  my  meals, 
fpruce  beer.  I  had  fo  high  an  opinion  of  this  medicine  in  the 
gout,  and  of  fpruce  beer  as  an  antifcorbutic,  that  I  contemplated 
with  much  fatisfaftion,  and  with  very  little  doubt,  the  perfecl 
reftoration  of  my  health  and  ftrength  ;  but  I  was  miferably  de- 
ceived 5  for  in  September  1788  I  was  feized  with  the  gout  in  a 
degree  that  none  but  arthritics,  and  indeed  but  few  of  thefe, 
can  eafily  conceive.  From  this  time  till  Auguft  1789  I  fcarcely 
ever  paifed  a  comfortable  day  -9  fevcn  months  of  this  time  I  had 
been  confined,  my  health  feemed  much  impaired,  my  ftrength 
was  diminilhed,  and  my  appetit*  almoft  gone.  In  this  (late  my 
friends  prefTed  me  to  confult  you.  I  was  unwilling  for  fome 
time  to  do  it,  as  I  had  loft  all  hope  of  relief ;  however,  when  I 
had  detrmined  to  apply  to  you,  I  likewife  determined  to  give  up 
every  prejudice  of  my  own  refpeding  my  cafe,  and  to  adhere 
mod  ftriftly  to  your  advice.  On  the  2oth  of  Auguft  1789  I 
confulted  you,  on  the  25th  I  entered  upon  the  regimen,  which 
you  prefcribed,  and  which  was  as  follows. 

"  Drink  no  malt  liquor  on  any  account.  Let  your  beverage  at 
"  dinner  confift  of  two  glafTes  of  wine  diluted  with  three  half- 
«  pints  of  water.  On  no  account  drink  any  more  wine  or  fpir- 
"  ituous  liquors  in  the  courfe  of  the  day  ;  but,  if  you  want  more 
<£  liquid,  take  cream  and  water,  or  milk  and  water,  or  lemonade, 
«  with  tea,  coffee,  chocolate.  Ufe  the  warm  bath  twice  a  week 
"  for  half  an  hour  before  going  to  bed,  at  the  degree  of  heat 
"  which  is  moft  grateful  to  your  fenfations.  Eat  meat  conftant- 
"  ly  at  dinner,  and  with  any  kind  of  tender  vegetables  you  pleafe. 
ff  Keep  the  body  open  by  two  evacuations  daily,  if  poflible 
"  without  medicine,  if  not  take  the  fize  of  a  nutmeg  of  lenitive 
«  elecluary  occafionally,  or  five  grains  of  rhubarb  every  night. 
«  Ufe  no  violent  exercife,  which  may  fubjeft  yourfelf  to  fudden 
"  changes  from  heat  to  cold  ;  but  as  much  moderate  exercife  as 
"  may  be,  without  being  much  fatigued  or  ftarved  with  cold. 
"  Take  fome  fupper  every  night ;  a  fmall  quantity  of  animal 
"  food  is  preferred ;  but  if  your  palate  refutes  this,  take  veg- 
«  etable  food,  as  fruit-pie,  or  milk ;  fomething  mould  be  eaten, 
«  as  it  might  be  injurious  to  you  to  faft  too  long."  To  the  whole 
of  this  I  adhered  moft  fcrupuloufly,  and  foon  found  my  appetite 
improve,  and  with  it  my  ftrength  and  fpirits.  I  had  in  Decem- 
ber a  fevere  attack,  and  two  or  three  flight  ones  in  the  courfe  of 
twelve  months  ;  but  the  improvement  in  the  general  ftate  of  my 
health  induced  me  to  perfevere.  On  the  i8th  of  Auguft  1790 
I  had  another  fevere  attack,  but  it  went  off  eafier  than  before, 
and  I  foon  recovered  fufficicntly  to  go  to  Buxton,  which  you  ad- 

vifed 


i.  2.  i$.     OF  ASSOCIATION.  305 

vifed  me  to,  and  from  which  I  reaped  great  benefit ;  neverthe- 
lefs  on  the  2pth  of  December  I  had  a  flight  attack  in  compari- 
fon  of  fome  that  I  had  before  experienced,  and  from  that 
time  I  was  free  from  gout,  and  enjoyed  my  health  perfectly  well 
till  the  fourth  week  in  October  1791  ;  from  that  till  the  third 
week  in  October  1792  \  from  that  till  the  third  week  in  Octo- 
ber  1793  j  and  from  that  till  June  1794.  From  what  happen- 
ed for  the  laft  three  years  I  dreaded  the  month  of  October  5 
but  I  Heaped  then,  and  have  enjoyed  my  health  mod  perfectly 
ever  fmce  till  within  the  lad  week,  that  I  have  had  a  ilight  at- 
tack in  one  knee,  which  is  nearly  gone,  without  any  fymptom  to 
lead  me  to  fuppofe  that  it  will  go  further. 

"  I  adhered  to  your  advice  moft  fcrupuloufly  for  the  firft  year; 
and  in  regard  to  the  not  drinking  malt  liquor,  and  taking  only 
the  two  glafles  of  wine  with  water,  I  have  never  deviated  but 
two  days ;  and  then  the  firft  day  I  only  drank  one  glafs  of  ale 
and  one  glafs  of  champaigne  \  on  the  fecorid  only  one  glafs  of 
champaigne.  With  regard  to  the  warm  bath,  I  only  ufe  it  now 
when  I  have  gouty  fymptoms  upon  me,  and  in  fuch  fituations 
I  find  it  of  infinite  fervice  ;  and  in  other  refpects  I  continue  to 
live  according  to  your  direction. 

«  Many  perfons  have  laughed  at  the  idea  of  my  perfeverance 
in  a  fyftem,  which  has  not  been  able  to  cure  the  gout  after  five 
years'  trial ;  but  fuch  perfons  are  either  ignorant  of  what  I  be- 
fore fu  fibred,  or  totally  unacquainted  with  the  nature  of  the  dif- 
order.  Under  the  blefling  of  Providence,  by  an  adherence  to 
your  advice,  I  am  reaping  all  the  benefit  you  flattered  me  I 
might  expect  from  it,  viz.  my  attacks  lets  frequent,  my  fuffer- 
ings  lefs  acute,  and  an  improvement  in  the  general  (late  of  my 
health, 

"  I  have  been  particular  in  this  account  of  myfelf  at  your  re- 
queft,  and  am,£ir,  &c. 

MORLEY,  near  DERBY, 
February  10^,1795.  ROBERT  WILMOT.*' 

There  are  fituations  neverthelefs  in  which  a  paroxyfm  of  gou-. 
has  been  believed  to  be  defirable,  as  relieving  the  patient  from 
other  difagreeable  difeafes,  or  debilities,  or  fenfations.  Thus 
when  the  liver  is  torpid,  a  perpetual  uneafmefs  and  depreflion 
of  fpirits  occur ;  which  a  fit  of  gout  is  fuppofed  to  cure  by  a 
metaftafis  of  the  difeafe.  Others  have  acquired  epileptic  fits, 
probably  from  the  difagreeable  fenfadon  of  a  chronically  inflam- 
ed liver  j  which  they  fuppofe  the  pain  and  inflammation  of  gout 
would  relieve.  When  gouty  patients  become  much  debilitated 
by  the  progrefs  of  the  difeafe,  they  are  liable  to  dropfy  of  the 

VOL,  IT.  B  B  H  cheft, 


386  DISEASES          CLASS  IV.  i.  2.  15- 

cheft,  which  they  fuppofe  a  fit  of  the  gout  would  relieve.  But 
in  all  thefe  cafes  the  attempt  to  procure  a  paroxyfm  of  gout  by 
wine,  or  aromatics,  or  volatiles,  or  blifters,  or  mineral  waters, 
feldom  fucceeds  •,  and  the  patients  are  obliged  to  apply  to  oth- 
er methods  of  relief  adapted  to  other  particular  cafes.  In  the 
two  former  fituations  fmall  repeated  dofes  of  calomel,  or  mer- 
curial unction  on  the  region  of  the  liver,  may  fucceed,  by  giv- 
ing new  activity  to  the  veffels  of  the  liver,  either  to  fecrete  or 
to  abforb  their  adapted  fluids,  and  thus  to  remove  the  caufe  of* 
the  gout,  rather  than  to  promote  a  fit  of  it.  In  the  laft  cafe  the 
tinclure  of  digitalis,  and  afterwards  the  clafs  of  forbentia,  muft 
be  applied  to. 

M.  M.  In  young  ftrong  patients  the  gout  (hould  be  cured 
by  venefection  and  cathartics  and  diluents,  with  poultices  ex- 
ternally. But  it  has  a  natural  crifis  by  producing  calcareous 
matter  on  the  inflamed  membrane,  and  therefore  in  old  enfee- 
bled people  it  is  fafeft  to  wait  for  this  crifis,  attending  to  the 
natural  evacuations  and  the  degree  of  fever  ;  and  in  young  ones, 
where  it  is  not  attended  with  much  fever,  it  is  cuftomary  and 
popular  not  to  bleed,  but  only  to  keep  the  body  open  with  aloes, 
to  ufe  gentle  fudorifics,  as  neutral  falts,  and  to  give  the  bark  at 
the  decline  of  the  fit  ;  which  is  particularly  ufeful  where  the 
patient  is  much  debilitated.  See  Arthritis  ventriculi,  Clafs  I. 
2.4.  6.  and  Seft.  XXV.  17. 

Mr.  Kelly,  furgeon  in  the  navy,  in  an  ingenious  treatife, 
printed  at  Edinb.  1797,  termed  Obfervations  on  Compreflion 
by  the  Tourniquet,  advifes  in  both  inflammatory  and  chronic 
rheumatifrn  to  comprefs  the  artery  of  the  affected  limb  by  the 
tourniquet,  for  15  or  20  minutes,  relaxing  or  tightening  the 
bandage,  as  the  patient  feems  to  bear  it.  And  in  inflammatory 
rheumatifm,  he  advifes  to  take  blood  from  a  vein  below  the 
bandage,  which  he  fays  relieves  the  pain  and  deftroys  the  in- 
flammation. Could  not  this  experiment  be  ufed  fafely  in  the 
gout  of  young  or  ftrong  patients  ?  and  perhaps  with  fpeedy 
fuccefs  ? 

When  there  is  not  much  fever,  and  the  patient  is  debilitated 
with  age,  or  the  continuance  of  the  difeafe,  a  moderate  opiate, 
as  twenty  drops  of  tincture  of  opium,  or  one  grain  of  folid  opi- 
um, may  be  taken  every  night  with  advantage.  Externally  a 
pafte  made  with  double  the  quantity  of  yeft  is  a  good  poultice  ; 
and  booterkins  made  with  oiled  (ilk,' as  they  confine  the  perfpir- 
able  matter,  keep  the  part  moift  and  fupple,  and  thence  relieve 
the  pain  like  poultices. 

The  only  fafe  way  of  moderating  the  difeafe  is  by  an  uniform 
and  equal  diminution,  or  a  total  abftinence  from  fermented 

liquors, 


CLASS  IV.  i.  2. 16.     OF  ASSOCIATION.  387 

liquors,  with  the  cautions  directed  in  Sect.  XII.  7.  8.  The 
continued  ufe  of  ftrong  bitters,  as  of  Portland's  powder,  or  bark, 
has  been  frequently  injurious,  as  fpoken  of  in  the  Materia  Med- 
ica,  Art.  IV.  2.  n. 

One  of  my  acquaintance,  who  was  much  afflicted  with  the 
gout,  abftained  for  about  half  a  year  from  beer  and  wine ;  and 
not  having  refolution  to  perfift,  returned  to  his  former  habits  of 
potation  in  lefs  quantity  ;  and  obferved  that  he  was  then  for  one 
winter  ftronger  and  freer  from  the  gout  than  ufual.  This  how- 
ever did  not  long  continue,  as  the  difeafe  afterwards  returned  with 
its  ufual  or  increafed  violence.  This  I  think  is  a  circumftance 
not  unlikely  to  occur,  as  opium  has  a  greater  effect  after  its  uie 
has  been  a  while  intermitted  ;  and  the  debility  or  torpor,  which 
is  the  caufe  of  gout,  is  thus  for  a  few  months  prevented  by  the 
greater  irritability  of  the  fyftem,  acquired  during  the  leflened 
ufe  of  fermented  liquor. 

For  the  fame  reafon  an  ounce  of  fpirituous  tincture  of  guaia*- 
cum,  or  of  bark,  is  faid  to  have  for  fome  time  prevented  returns 
of  the  gout  *,  which  has  afterwards,  like  all  other  great  ftimult 
when  long  continued,  been  fucceeded  by  greater  debility,  and 
deftroyed  the  patient.  This  feems  to  have  been  exemplified  in 
the  cafe  of  the  ingenious  Dr.  Brown,  fee  Preface  to  his  Ele- 
menta  Medicinse  ;  he  found  temporary  relief  from  the  ftimulus 
of  wine,  regardlefs  of  its  future  effects. 

Laftly,  as  the  gouty  inflammation,  like  the  rheumatic  fwellings 
of  the  wrifts  and  ankles,  is  not  a  primary  difeafe  ;  and  is  like 
them  not  liable  to  fuppurate  ;  there  is  reafon  to  believe  that  opi- 
ates may  be  given  with  lefs  danger  than  in  other  inflammations, 
and  with  a  profpect  of  advantage ;  fince  by  preventing  the  pe- 
riods of  torpor  of  the  liver,  or  other  part,  primarily  affected,  the 
diurnal  additional  attack,  or  its  producing  inflammation  of 
another  limb,  may  fometimes  be  prevented.  A  perfon  a  few 
days  ago  affured  me,  that  when  the  gout  came  into  his  foot,  his 
practice  was  to  take  thirty  drops  of  tincture  of  opium  ;  and  in 
half  an  hour  thirty  drops  more  ;  and  even  a  third  dofe,  if  the 
pain  did  not  fubfide  ;  and  that  the  fit  foon  ceafed.  I  fhould 
think  this  a  dangerous  experiment.  A  Mr.  Warner  wrote  a 
book  recommending  opium  in  the  gout,  but  died  foon  after  its 
publication. 

1 6.  Rhcttmatifmus.  Acute  rheumatifm.  There  is  reafon  to 
fufpect,  that  rheumatic  inflammations,  like  the  gouty  ones,  are 
not  a  primary  difeafe ;  but  that  they  are  the  confequence  of  a 
tranflation  of  morbid  action  from  one  part  of  the  fyftem  to 
another.  This  idea  is  countenanced  by  the  frequent  change  of 
place  of  rheumatic-like  gouty  inflammations,  and  from  their  at- 
tacking 


DISEASES  CLASS  IV.  1.3.16. 

tacking  two  fimilar  parts  at  the  fame  time,  as  both  ankles  and 
both  wrifls,  and  thefe  attacks  being  in  fucceffion  to  each  other. 
Whereas  it  is  not  probable  that  both  feet  or  both  hands  fhould 
at  the  fame  time  be  equally  expofed  to  any  external  caufe  of  the 
difeafe,  as  to  cold  or  moifture ;  and  lefs  fo  that  thefe  fhould  oc- 
cur in  fucceffion.  Laftly,  from  the  inflammatory  diathefis  in 
this  difeafe  being  more  difficult  to  fubdue,  and  more  dangerous 
in  event,  than  other  common  inflammations,  efpecially  to  preg- 
nant women,  and  in  weak  conflitutions. 

From  this  idea  of  the  rheumatifm  being  not  a  primary  dif- 
eafe, like  the  gout,  but  a  transferred  morbid  action  owing  to  the 
previous  torpor  of  fome  other  part  of  the  fyftem,  we  perceive 
why  it  attacks  weak  people  with  greater  pertinacity  than  ilrong 
ones ;  refilling  or  recurring  again  and  again  after  frequent  evac- 
.is,  in  a  manner  very  different  from  primary  inflammations  5 
:ife  the  caufe  is  not  removed,  which  is  at  adiftance  from  the 
feat  of  the  inflammation. 

This  alfo  accounts  for  rheumatic  inflammations  fo  very  rarely 
terminating  in  fuppuration,  becaufe  like  the  gout  the  original 
caufe  is  not  in  the  inflamed  part>  and  therefore  does  not  con- 
tinue to  aft  after  the  inflammation  commences,  Inftead  of  fup- 
puration  in  this  difeafe,  as  well  as  in  the  gout,  a  quantity  of 
mucus  or  coagulable  lymph  is  formed  on  the  inflamed  mem- 
brane ;  which  in  the  gout  changes  into  chalk-ftones,  and  in  the 
rheumatifm  is  either  reabforbed,  or  lies  on  the  membrane,  pro- 
ducing pains  on  motion  long  after  the  termination  of  the  inflam-. 
mation,  which  pains  are  called  chronic  rheumatifm.  The  mem- 
branes, which  have  thus  been  once  or  repeatedly  inflamed,  become 
3efs  mobile,  or  lefs  liable  to  be  affected  by  fympathy,  as  appears 
by  the  gout  affecting  new  parts,  when  the  joints  of  the  foot 
have  been  frequently  inflamed  by  it  5  hence  as  the  caufe  of  the 
inflammation  does  not  exity  in  the  inflamed  part,  and  as  this 
part  becomes  lefs  liable  to  future  attacks,  it  feldorn  fuppurates. 

Pleurodyne  rheumatic  a.  When  rheumatifm  affeds  the 
xnufcles  of  the  cheft,  it  produces  fymptoms  fimUar  to  pleu- 
ri<>,  but  diftinguifhed  from  it  by  the  patient  having  previouily 
{uffered  rheumatic  affections  in  other  parts,  and  by  the  perti- 
nacity or  continuance  of  the  inflammatory  ftate  of  the  patient. 
This  fhould  be  termed  pleurodyne  rheumatica. 

Enter algick  rheumatica.  When  rheumatic  inflammation 
fects  the  bowels,  it  produces  a  difeafe  very  different  from  en- 
teritis, or  common  hrHammation  of  the  bowels,  and  fhould  be 
termed  interalgia  rheumatica,  The  pain  is  lefs  than  in  enteri* 
tis,  and  the  difeafe  of  longer  continuance,  with  harder  pulfe,  and 
the  blood  equally  fizy.  It  is  attended  with  frequent  dejections* 

with 


CLASS  IV.  i.  2. 16.     OF  ASSOCIATION,  389 

with  much  mucus,  and  previous  griping  pains,  but  without 
vomiting ;  and  differs  perhaps  from  dyfentery  from  its  not  be- 
ing attended  with  bloody  (tools,  and  not  being  infectious. 

Rheumatic  inflammations,  which  I  believe  to  arife  from  the 
fympathy  of  the  inflamed  part  with  the  torpor  of  fome  diftant 
part,  may  I  think  be  certainly  diftinguifhed  from  thofe  inflam- 
mations of  the  fame  part,  which  have  not  arifen  from  fympathy 
with  the  torpor  of  fome  diftant  part,  but  where  the  caufe  of  the 
inflammation  began  in  the  part  where  the  inflammation  exifts, 
by  this  circumftance  ;  that  in  rheumatic  inflammation  the  hard 
or  (harp  pulfe  continues  at  about  1 1 8  in  a  minute  after  the  pain 
abates  or  ceafes.  Whereas  in  the  latter  the  inflammatory  fever 
ceafes  along  with  the  pain. 

In  two  cafes  of  pain  of  the  fide,  and  difficult  refpiration, 
which  I  efteemed  rheumatic,  as  the  hard  pulfe  of  1 1 8  with  fized 
blood  continued  after  repeated  venefection,  gentle  cathartics, 
and  mild  antimonials,  I  found  ten  drops  of  faturated  tincture  of 
digitalis  given  every  fix  hours  appear  to  produce  great  good  ef- 
fect, and  to  abate  and  remove  the  inflammatory  diathefis  in  three 
or  four  days. 

Hence  when  a  fever  has  continued  more  than  one  lunar  pe- 
riod, attended  with  a  hard  or  {harp  pulfe  of  1 1 8  or  1 20  in  a 
minute,  and  is  not  attended  with  cough  or  fymptoms  of  abforb- 
ed  matter,  it  may  be  efteemed  of  rheumatic  origin,  though  no 
local  pain  or  inflammation  at  prefent  exifts  j  and  this  with  great- 
er certainty,  if  pain  had  previoufly  exilled  :  for  no  fevers,  ex- 
cept the  hectic  fevers  from  abforbed  matter,  and  this  attended 
with  inflammatory  diathefis,  and  which  may  be  called  rheumat- 
ic, ever  properly  extend,  I  believe,  beyond  one  lunation  ;  though 
fymptoms  of  debility  may  continue  a  while  longer.  This  ob- 
fervation  is  worth  attending  to  in  practice,  as  it  diftinguimes 
the  kind  of  fever,  in  which  when  the  bark  is  erroneoufly  givrn, 
it  does  no  fervice3  and  in  which  I  believe  faturated  tincture  of 
digitalis  given  as  above  to  be  the  moil  efficacious  medicine. 

Rheumatifmtts  fuppurans.  There  is  another  kind  of  rheuma- 
tifm  attended  with  debility>  which  fuppurates,  and  mould  be 
termed  rheumatiimus  fuppurans.  It  is  generally  believed  to  be 
the  gout,  till  fuppuration  takes  place  on  the  (Welled  joint  5  and, 
as  the  patient  finks,  there  are  Houghs  formed  over  the  whole 
mouth ;  and  he  ieems  to  be  deftroyed  by  inflammation  or  gan- 
grene of  the  mucous  membranes.  I  nave  twice  feen  this  dif- 
eafe  in  patients  about  fixty.  Some  other  difcafes  are  crroneouf- 
Jy  called  rheumatic,  as  hemicraaia,  and  odontalgia.  See  Sect. 
«XV1.  3. 

M.  M.  In  the  three  former  kinds  venefe&ion  repeatedly.  Ca- 
thartics, 


390  DISEASES  CLASS  IV.  i.  2.  16: 

thartics.  Antimonials.  Diluents.  Neutral  falts.  Oil.  Warm 
bath.  Afterwards  the  bark.  Opium  with  or  without  ipecacu- 
anha j  but  not  till  the  patient  is  confiderably  weakened.  Sweats 
forced  early  in  the  difeafe  do  injury.  Opium  given  early  in 
the  difeafe  prolongs  it.  In  the  laft  kind,  gentle  ftimulants,  as 
wine  and  water,  mucilage,  forbentia. 

In  acute  rheumatifm,  when  the  fwelling  of  the  joints  firft  af- 
fected fubfides,  a  return  of  torpor  in  the  part  primarily  difeafed 
commences  previous  to  an  inflammation  of  the  joints  fecondari- 
ly  affected.  Hence  when  the  tumor  of  the  joints  firft  affected 
fubfides,  half  a  grain  of  opium,  every  night,  and  Peruvian  bark, 
or  other  bitter  medicine,  may  be  given  to  prevent  this  return 
of  torpor  with  great  advantage  ;  if  the  patient  has  previoufly 
been  properly  evacuated,  and  is  not  now  too  much  inflamed. 

Dr.  Fordyce  afierts,  that  when  it  was  the  practice  to  bleed 
largely  ia  acute  rheurnntifrn,  a  metaftafis  frequently  took  place 
to  the  interior  parts  of  the  body,  and  deftroyed  the  patient.  And 
adds,  that  during  the  laft  fit  teen  years  of  his  practice  this  has 
rarely  happened,  as  he  has  entirely  left  off  bleeding  in  the  acute 
rheumatifm.  Third  diflertation  on  fever  by  G.  Fordyce,  M.  D. 
London,  Johnfou.  On  this  fubject  it  may  be  remar)  ,:d,  that  as 
rheumatifm  like  gout  is  a  fecondary  difeafe,  the  inflammation 
of  one  part  being  fymptoraatic,  the  feat  of  torpor  exifting  in 
ibme  other  part,  it  may  not  be  fo  conftantly  neceffary  to  bleed 
fo  copiouily  in  thofe  fecondary  inflammatory  difeafes,  as  in  thofe 
primary  ones,  where  the  inflamed  part  was  previoufly  the  feat 
of  torpor,,  as  in  pleurify,  peripneumony,  and  intends  j  but  in 
rheumatifm,  as  well  as  in  eryfipelas,  I  am  convinced,  that  where 
the  inflammation  of  the  fyftem  is  great,  repeated  venefection  is 
not  only  ufeful ;  but  that  thofe,  who  perifh  by  either  of  thofe 
difeafes,  perifti  for  the  want  of  venefection  'early,  where  the  at- 
tack is  violent.  And  laftly,  that  even  in  the  gout  of  young  and 
ftrong  ftubjects,  as  I  know  by  experience  on  myfelf,  a  moderate 
venefection  fhortens  the  fit,  and  leflens  I  believe  the  hazard  of 
metaftafis. 

The  following  is  a  cafe  of  fuppurative  rheumatifm.  Mr. 

F ,  about  fixty,  was  fuppofed  to  have  the  gout  in  his  hand, 

which  however  fuppurated,  and  it  was  then  called  the  fuppurai- 
tive  rheumatifm.  He  had  lived  rather  intemperately  in  refpect 
to  wine,  and  was  now  afflicted  with  a  tendency  to  inflammation 
of  the  mucous  membranes.  As  he  lay  on  the  bed  half  refupine, 
propped  up  with  pillows,  and  alfo  flept  in  "that  pofture,  his  lower 
jaw  dropped  by  its  own  weight,  when  the  voluntary  power  of 
the  mufcles  was  fufpended.  The  mucus  of  his  mouth  antl 
throat  became  quite  dry,  and  at  length  was  fucceeded  by  floughs  ; 

this 


CLASS  IV.  i .  2. 1 7*      OF  ASSOCIATION,  391 

this  was  a  moft  diftreflmg  circumftance  to  him,  and  was  in  vain 
endeavoured  to  be  relieved  by  fupporting  his  jaw  by  Header 
fleel  fprings  fixed  to  his  night-cap,  and  by  fprings  of  elaftic  gum. 
The  flougha  fpread  and  feemed  to  accelerate  his  death.  See 
Clafs  I.  i.  3.  2. 

In  acute  rheumatiim  Mr.  Keliie  aflerts  that  he  has  had  great 
fuccefs  by  putting  a  tourniquet  on  the  affe&ed  limb,  fo  as  to 
comprefs  the  artery,  and  then  by  taking  blood  from  a  vein  below 
the  bandage, as  mentioned  above  in  Podagra.  Clafs  IV.  i.  2.  15. 
17.  Eryfipelas.  The  eryfipelas  differs  from  the  zona  ignea, 
and  other  fpecies  of  herpes,  in  its  being  attended  with  fever, 
which  is  fometimes  of  the  fenfitive  irritated  or  inflammatory 
kind,  with  ftrong  and  full  pulfe  •,  and  at  other  times  with  weak 
pulfe  and  great  inirritability,  as  when  it  precedes  or  attends 
mortifications.  See  Clafs  II.  i.  3.  2. 

Like  the  zona  ignea  above  defcribed,  it  feems  to  be  a  fecond- 
ary  difeafe,  having  for  its  primary  part  the  torpor  or  inflam- 
mation of  fome  internal  or  diltant  membrane,  as  appears  from 
its  fo  frequently  attending  wounds  5  fometimes  fpreading  from 
iflues  over  the  whole  limb,  or  back,  by  fympathy  with  a  tendon 
or  membrane,  which  is  ftimulated  by  the  peafe  in  them.  In 
its  more  violent  degree  I  fuppofe  that  it  fympathizes  with  fome 
extenfive  internal  membranes,  as  of  the  liver,  ftomach,  or  brain. 
Another  reafon,  which  countenances  this  idea,  is,  that  the  in- 
flammation gradually  changes  its  fituation,  one  part  healing  as 
another  inflames  ;  as  happens  in  refpe£l  to  more  diftant  parts  in 
gout  and  rheumatifm  ;  and  which  feems  to  (hew,  that  the  caufe  of 
the  difeafe  is  not  in  the  fame  place  with  the  inflammation.  And 
thirdly,  becaufe  the  eryCpelas  of  the  face  and  head  is  liable  to 
afFecl:  the  memb  ranes  of  the  brain  ;  which  were  probably  in 
thefe  cafes  the  original  or  primary  feat  of  the  difeafe  ;  and  laftly, 
becaufe  the  fits  of  eryfipelas,  like  thofe  of  the  gout,  are  liable 
to  return  at  certain  annual  or  monthly  periods,  as  further  treat- 
ed of  in  Clafs  II.  i.  3.  2. 

Many  cafes  of  eryfipelas  from  wounds  or  bruifes  are  related 
in  Default's  Surgical  Journal,  Vol.  II.  in  which  poultices  are 
faid  to  do  great  injury,  as  well  as  oily  or  fatty  applications.  Sat- 
urnine folutions  were  fometimes  ufed  with  advantage.  A 
grain  of  emetic  tartar  given  to  clear  the  ftomach  and  bo\vels,  is 
faid  to  be  of  great  fervice. 

1 8.  Tejlittm  tumor  in  gonorrhoea.  Mf?  Hunter  in  his  Treat!  u; 
on  the  Venereal  Difeafe  obferves,  that  the  tumor  of  the  teiles  in 
gonorrhoea  arifes  from  their  fympathy  with  the  inflammation  of 
the  urethra ;  and  that  they  are  not  fimilar  to  the  actions  arifing 
worn  the  application  of  venereal  matter,  whether  by  abforption 

or 


39*  DISEASES  CLASS  IV.  i.  2<  19'* 

or  otherwife  j  as  they  feldom  or  never  fuppurate  ;  and  when 
fuppuration  happens,  the  matter  produced  is  not  venereal.  Trea- 
tife  on  Venereal  Difeafe,  p.  53. 

19.  Teftium  tumor  inparotidiu.  The  fympathy  between  fome 
parts  about  the  throat  and  the  genitals  has  been  treated  of  in 
Clafs  IV".  i.  2.  7.  The  fwelling  of  the  teftes,  when  that  of 
the  parotis  fubfides,  feems  to  arife  from  the  aflbciation  of  fuo 
ceflive  aclion  ;  as  the  tenfion  of  the  penis  in  hydrophobia  appears 
to  arife  from  the  previous  fynchronous  aflbciations  of  the  fenfi- 
tive  motions  of  thefe  parts ;  but  the  manner  of  the  production 
of  both  thefe  afibciations  is  yet  very  obfcure,  In  women  a 
fwelling  of  the  breads  often  fucceeds  the  decline  of  the  mumps 
by  another  wonderful  fympathy.  See  Clafs  IV.  i.  2.  7.  and 
I.  i.  2.  15.  In  many  perfons  a  delirium  fucceeds  the  fwelling 
of  the  parotis,  or  the  fubfequent  ones  of  the  teftes  or  breads  ; 
which  is  fometimes  fatal,  and  feems  to  arife  from  a  fympathy  of 
fuccefTive  action,  and  not  of  fynchronous  aftion,  of  the  mem* 
branes  of  the  brain  with  thofe  of  the  parotid  glands.  Sometimes 
a  ftupor  comes  on  inftead  of  this  delirium,  which  is  relieved  by 
fomenting  the  fliaved  head  for  an  hour  or  two.  See  Clafs  II. 
i.  3.  4. 


DRDO 


CLASS IV.  i.  3.  i.       OF  ASSOCIATION.  393 

ORDO  I. 

Increafed  Affodale  Motions. 

GENUS  III. 

Catenated  with  Voluntary  Motions. 
SPECIES. 

1.  Deglutitio  invita.      "When  any  one  is  told  not  to  fwal° 
low  his  faliva,  and  that  efpecially  if  his  throat  be  a  little  fore, 
he  finds  a  neceflity  of  immediately  fwalfowing  it ;    and  this 
the  more  certainly,  the  more  he  voluntarily  endeavours  not  to 
do  fo. 

In  this  cafe  the  voluntary  power  exerted  by  our  attention  td 
the  pharynx  renders  it  more  fenfible  to  irritation,  and  therefore 
occafions  it  to  be  more  frequently  induced  to  fwallow  the  fali- 
va. Here  the  irritation  induces  a  volition  to  fwallow  it,  which 
is  more  powerful  than  the  defire  not  to  fwallow  it.  See  XXIV. 
1.7.  So  in  reverie,  when  the  voluntary  power  was  exerted 
on  any  of  the  fenfes,  as  of  fight  or  tafte,  the  objects  of  thofe 
fenfes  became  perceived  ;  but  not  otherwife.  Sect.  XIX.  6. 
This  is  a  troublefome  fymptom  in  fome  fore  throats. 

M.  M.  Mucilage,  as  fugar  and  gum  arabic. 

Warm  water  held  in  the  mouth  frequently,  a  fomentation  to 
the  inflamed  throat. 

2.  Niflitatio  inviia.     Involuntary  winking  with  the  eye-lids, 
and  twitchings  of  the  face,  are  originally  induced  by  an  en- 
deavour to  relieve  fome  difagreeable  fenfations  about  inflamed 
eyes,  as  the  dazzling  of  light ;  and  afterwards  thefe  motions  be- 
come catenated  with  other  motions  or  fenfations,  fo  as  not  to  be 
governed  by  the  will.     Here  the   irritation  firft  produces  a  vo- 
lition to  wink,  which  by  habit  becomes  ftronger  than  the  anti- 
volition  not  to  wink. 

This  fubjedt  is  rendered  difficult  from  the  common  accepta- 
tion of  the  word,  volition,  including  previous  deliberation,  as 
well  as  the  voluntary  exertion,  which  fucceeds  it.  In  the  voli- 
tions here  fpoken  of  there  is  no  time  for  deliberation  or  choice 
of  objects,  but  the  voluntary  act  immediately  fuccteds  the  fen- 
fatiorj  which  excites  it. 

M.  M.  Cover  the  affected  parts  with  a  flicking  plafter  or  a 
blifter.  Pafs  a  fine  needle  and  thread  through  a  part  of  the 
iliin  over  the  mufcle,  which  moves,  and  attach  the  other  end  of 

VOL.  II,  C  c  c  the 


394  DISEASES  CLASS  IV.  1.3.3, 

the  thread  by  a  {licking  plafter  to  a  diftant  part.  An  iflue  be- 
hind the  ear.  To  praclife  daily  by  a  looking-glafs  to  ftop  the 
motions  with  the  hand.  See  the  cure  of  a  cafe  of  the  leaping  of 
a  mufcle  of  the  arm,  Sec~l.  XVII.  i.  8.  See  Convulfio  debi* 
lis,  Clafs  III.  i.  i.  5.  Frequent  eleclric  fparks,  or  very  flight 
(hocks.  . 

3.  Rifus  invitus.     Involuntary  laughter.     When  the  pleafure 
ariftng  from  new  combinations  of  words  and  ideas,  as  in  puns ; 
or  of  other  circumftances,  which  are  fo  trivial,  as  to  induce  no 
voluntary  exertion  to  compare  or  confider  their  prefent  impor- 
tance or  their  future  confeqiience  ;  the  pleafure  is  liable  to  rife 
into  pain  5  that  is,  the  ideas  or  fenfual  motions  become  exerted 
too  violently  for  want  of  fome  antithefiftic  ideas  ;  in  the  fame 
manner  as  thofe  mufcles,  which  have  weak  antagonifts,as  thpfe  of 
the  calf  of  the  leg,  are  liable  to  fall  into  cramp  or  painful  contrac- 
tion.    In  this  fituation  a  fcream  is  begun  to  relieve  this  pain  of 
ideas  too  violently  exerted,  which  is  ftopped  again  foon,  as  ex- 
plained in  Sea.  XXXIV.   i.  4.  and  Clafs  III.  i.  i.  4.  and  IV. 

2.    3.    3. 

The  pain,  into  which  this  pleafure  rifes,  which  would  excite 
the  fcream  of  laughter,  has  been  felt  forcibly  by  every  one ; 
when  they  have  been  under  fuch  circumftances,  as  have  induc- 
ed them  to  reftrain  it  by  a  counter-volition  ;  till  at  length  the 
increafed  affociate  motions  produce  fo  much  pain  as  to  over- 
come the  counter-volition,  and  the  patient  burfls  out  into  inde- 
cent laughter,  contrary  to  his  will  in  the  common  acceptation  of 
that  word. 

4.  Litfus  digitorum  invitus.     An  awkward,  playing  with  the 
fingers  in  fpeaking  in  public.     Thefe  habits  are  begun  through 
bamfulnefs,  and  feem  rather  at  fir  ft  defigned  to  engage  the  at- 
tention in  part,  and  thus  prevent  the  difagreeable  ideas  of  mau* 
vaife  honte  ;  as  timorous  boys  whiftle,  when  they  are  obliged  to 
walk  in  the  dark ;  and  as  it  is  fometimes  neceflary  to  employ 
raw  foldiers  in  perpetual  manoeuvres,  as  they  advance  to  the 
firft  charge. 

5.  Unguium  morjiuncula  invita.      Biting  the  nails  is  a  de- 
praved habit  arifing  from  fimilar  caufes  as  thofe  of  the  laft  arti- 
cle. 

M.  M.  Dip  the  fingers  in  folutiori  of  aloes. 

6.  Vigilia  invita.     Watchfulnefs,  where  the  perfon  wifhes 
and  endeavours  to  fall  afleep,  properly  belongs  to  this  place,  as 
the  wifh  or  volition  to  fleep  prevents  the  defired  effect ;  be- 
caufe  fleep  confifts  in  an  abolition  of  volition.     See  Clafs  III. 

I.  2.  3. 

ORDO 


CLASS  IV.  i.  4.  i.       OF  ASSOCIATION.  395 

ORDO  I. 

Increafed  Affociate  Motions, 
GENUS  IV. 

Catenated  with  External  Influences, 

SPECIES, 

1 .  Vita  ovi.     Life  of  an  egg.     The  eggs  of  fowls  were  (hewn 
by  Mr.  J.  Hunter  to  refift  the  freezing  procefs  in  their  living 
ftate  more  powerfully  than"when  they  were  killed  by  having  the 
yolk  and  white  fhook  together.     Philof.  Tranf.     It  may  be  afk- 
cd,  does  the  heat  during  the  incubation  of  eggs  act  as  a  ftimulus 
exciting  the  living  principle  into  activity  ?  Or  does  it  act  fim- 
ply  as  a  caufa  fine  qua  non,  as  an  influence,  which  penetrating 
the  mafs,  removes  the  particles  of  it  to  a  greater  diftance  from 
each  other,  fo  as  to  allow  their  movement  over  each  other,  in  the 
fame  manner  as  heat  is  conceived  to  produce  the  fluidity  of  wa- 
ter ;  not  by  ftimulus,  but  by  its  penetrating  influence  ?  Or  may 
elementary  heat  i»  its  uncombined  ftate  be  fuppofed  to  act  only 
as  an  influence  neceflary  to  life  in  its  natural  quantity  5  whence 
torpor  and  death  follow  the  eduction  of  it  from  the  body  ;    but 
in  its  increafed  ftate  above  what  is  natural,  or  ufual,  that  it  acts 
as  a  ftimulus  •,  which  we  have  a  fenfe  to  perceive  j  and  which 
excites  many  parts  of   the  fyftem   into  unnatural  action  ?  Sec 
ClafsIV.   i.   i.  C. 

2.  Vita  hiemi-dormientium.     The  torpor  of  infects,  and  birds, 
and  quadrupeds,  during  the  cold  feafon,  has  been   called  fleep  ; 
but  I  fuppofe  it  muft  differ  very  much  from  that  ftate  of  animal 
life,  fmce  not  only  all   voluntary  power  is  fufpended,  but  fenfa- 
tion  and  vafcular  motion  have  qeafed,  and  can  only  be  reftored 
by  the  influence  of  heat.     There  have  been  related  inftances  of 
fnails,  which  have  recovered  life  and  motion  on  being  put  into 
water  after  having  experienced  many  years  of  torpidity,  or  ap- 
parent death,  in  the  cabinets  of  the  curious.     Here  the  water  as 
well  as  the  heat  are  required  not  only  as  a  ftimulus,  but   as  a 
caufa  fine  qua  non  of  fluidity  and  motion,  and  confequent  life. 

3.  Pullulatio  arboruni.     The  annual  revivefcence  of  the  buds 
of  trees  feems  not  only  to  be  owing  to  the  influence  of  the  re- 
turning warmth  of  the  fpring,  but  alfo  to  be  catenated  with  fo- 
lar  gravitation  -,    becaufe   feeds  and  roots  and  buds,  which  are 
analogous  to  the  eggs  of  animals,  put  forth  their  fhoots  by  a  lefs 

quantity 


DISEASES  CLASS  IV.  i.  4. 4, 

quantity  of  heat  in  fpring,  than  they  had  undergone  in  the  lat- 
ter part  of  autumn,  which  may  however  be  afcribed  to  their 
previous  torpid  ftate,  and  confequent  accumulation  of  fenforial 
power,  or  irritability  •,  as  explained  in  Botanic  Garden,  Part  II. 
Cant.  I.  1.  322.  note.  Other  circumftances,  which  counte- 
nance the  idea,  that  vegetation  is  affected  by  folar  gravitation,  as 
well  as  by  heat,  may  be  obferved  in  the  ripening  of  the  feeds  of 
plants  both  in  thofe  countries  where  the  fummers  are  mort, 
and  in  thofe  where  they  are  long.  And  by  fome  flowers  clof- 
ing  their  Sells  at  noon,  or  foon  after ;  and  hence  feem  to  fleep 
rather  at  folar  diurnal  periods,  than  from  the  influence  of  cold, 
or  the  deficiency  of  light. 

4.  Orgfifmatis  venerei  periodus.     The  venereal  orgafm  of  birds 
and  quadrupeds  commences  or  returns  about  the  vernal  or  au- 
tumnal equinoxes,  and  thence  feems  in  refpect  to  their  great 
periods  to  be  governed  by  folar  influence.     But  if  this  orgafm 
be  difappointed  of  its  object,  it  is  faid  to  recur  at  about  month- 
ly  periods,  as  obferved  in  mares  and  bitches,  in  this  refpect  re- 
fem'oling  the  female  catamenia.     See  Sect.  XXXVI.  2.  3.  and 
Sed.  XVI.  13. 

5.  Brachti  concujjlo  eleElrica.     The  movement  of  the  arm, 
even  of  a  paralytic  patient,  when  an  electric  mock  is  pafled 
through  it,  is  owing  to  the  ftimulus  of  the  excefs  of  electricity. 
When  a  piece  of  zinc  and  another  of  filver,  each  about  the  fize 
of  a  crown-piece,  are  placed  one  under  the  upper  lip,  and  the 
other  on  the  tongue,  fo  as  the  outer  edges  may  be  brought  into 
contact,  there  is  an  appearance  of  light  in  the  eyes,  as  often  as 
the  outer  edges  of  thefe  metals  are  brought  into  contact  or  fep- 
arated  \  which  is  another  inftance  of  the  ftimulus  of  the  pafTage 
of  electric  {hocks  through  the  fibres  of  the  organs  of  fenfe,  as 
•well  as  through  the  mufcular  fibres.     See  Seel.  XII.  i.  i.    But 
in  its  natural  ftate  electricity  feems  only  to  act  as  an  influence 
pn  animal  and  vegetable  bodies  \  of  the  falutary  or  injurious  ef- 
fects of  which  we  have  yet  no  prec\fe  knowledge. 

Yet  if  regular  journals  were  kept  of  the  variations  of  atmof- 
pheric  electricity,  it  is  probable  fome  difcoveries  of  its  influence 
on  our  fyftem  might  in  time  be  difcovered.  For  thispurpofe  a 
machine  on  the  principle  of  Mr.  Bennet's  electric  doubler  might 
be  applied  to  the  pendulum  of  a  clock,  fo  as  to  manifeft,  and 
even  to  record  the  daily  or  hourly  variations  of  aerial  electricity. 
Which  has  already  been  executed,  and  applied  to  the  pendu- 
lum of  a  Dutch  wooden  clock,  by  Mr,.  Bennet,  curate  of  Wirkf- 
worth  in  Derbyshire. 

Befides  the  variations  of  the  degree  or  kind  of  atmofpheric 
electricity,  fome  animals,  and  fome  men,  feem  to  poflefs  a  great- 
er 


CLASS  IV.  i .  4.  6.       OF  ASSOCIATION.  397 

er  power  of  accumulating  this  fluid  in  themfelves  than  others^ 
Of  which  a  famous  hiftory  of  a  Ruffian  prince  was  lately  pub* 
lifhed  ;  who,  during  the  clear  and  fevere  frofts  of  that  country, 
could  not  move  himfelf  in  bed  without  luminous  corrufcations. 
Such  may  have  been  the  cafe  of  thofe  people,  who  have  been 
related  to  have  taken  fire  fpontaneoufly,  and  to  have  been  reduced 
to  ames.  The  electric  concuffion  from  the  gymnotus  electricus, 
and  torpedo,  are  other  inftances  of  the  power  of  the  animal  fyf- 
tem  to  accumulate  electricity,  as  in  thefe  it  is  ufed  as  a  weapon 
of  defence,  or  for  the  purpofe  of  taking  their  prey. 

Some  have  believed  that  the  accumulation  or  pafTage  of  the 
magnetic  fluid  might  affect  the  animal  fyftem,  and  have  afierted 
that  the  application  of  a  large  magnet  to  an  aching  tooth  has 
quickly  effected  a  cure.  If  this  experiment  is  again  tried  in 
odontalgia,  or  hemicrania,  the  painful  membrane  of  the  tooth 
or  head  fhould  be  included  between  the  fouth  and  north  poles 
of  a  horfe-fhoe  magnet,  or  between  the  contrary  poles  of  two 
different  magnets,  that  the  magnetifm  may  be  accumulated  on 
the  torpid  part. 

6.  Qxygenatio  fanguinis.     The  variation  of  the  quantity  of 
oxygen  gas  exifting  in  the  atmofphere  muft  afFecl:  all  breathing 
animals ;  in  its  excefs  this  too  muft  be  efteemed  a  ftirnulus  ; 
but  in  its  natural  quantity  would  feem  to  aft  as  an  influence, 
or  caufe,  without  which  animal  life  cannot  exift  even  a  minute. 
It  is  hoped  that  Dr.  Beddoes's  plan  for  a  pneumatic  infirmary, 
for  the  purpofe  of  putting  this  and  various  other  airs  to  the  tefl 
of  experiment,  will  meet  with  public  encouragement,  and  ren- 
der confumption,  aflhma,  cancer,  and  many  difeafes  conquera- 
ble, which  at  prefent  prey  with  unremitted  devaftation  on  all 
orders  and  ages  of  mankind. 

7.  HumeRatio  corporis.     Water,  and  probably  the  vapour  of 
water  diflblved  or  diflfufed  in  the  atmofphere,  unites  by  mechan- 
ical attraction  with  the  unorganized  cuticle,  and  foftens  and  en- 
larges it ;  as  may  be  feen  in  the  loofe  and  wrinkled  fkin  of  the 
hands  of  wafher women  ;  the  fame  probably  occurs  to  the  mu- 
cous membrane  of  the  lungs  in  moift  weather ;  and  by  thick- 
ening it  increafes  the  difficulty  of  refpiration  of  fome   people, 
who  are  faid  to  be  afthmatical.     So  far  water  may  be  faid  to 
aft  as  an  influx  or  influence,  but  when  it  is  taken  up  by  the 
mouths  of  the  abforbent  fyftem,  it  muft  excite  thofe  mouths  into 
action,  and  then  acts  as  a  ftimulus. 

There  appears  from  hence  to  be  four  methods  by  which  ani- 
mal bodies  are  penetrated  by  external  things,  i.  By  their  ftim- 
ulus, which  induces  the  abforbent  veflels  to  imbibe  them.  2.  By 
mechanical  attraction,  as  when  water  foftens  the  cuticle.  3.  By 

chemical 


DISEASES  CLASS  IV.  i.  4. 7. 

chemical  attraction,  as  when  oxygen  pafTes  through  the  menu 
branes  of  the  air-veflels  of  the  lungs,  and  combines  with  the 
blood.  And  laftly,  by  influx  without  mechanical  attraction, 
chemical  combination,  or  animal  abforption,  as  the  univerfal 
fluids  of  heat,  gravitation,  electricity,  magnedfm,  and  perhaps 
of  other  etherial  fluids  yet  unknown. 


ORDO 


CLASS  IV*  2.  i.          OF  ASSOCIATION.  399 

ORDO  II. 

Decreafed  AJJociate  Motions* 

GENUS  I. 
Catenated  with  irritative  Motion*. 

As  irritative  mufcular  motions  are  attended  w  ith  pain,  when 
they  are  exerted  too  weakly,  as  well  as  when  they  are  exerted 
too  ftrongly  •,  fo  irritative  ideas  become  attended  with  fenfation 
when  they  are  exerted  too  weakly,  as  well  as  when  they  are  ex- 
erted too  ftrongly.  Which  accounts  for  thefe  ideas  being  at- 
tended with  fenfation  in  the  various  kinds  of  Vertigo  defcribed 
below. 

There  is  great  difficulty  in  tracing  the  immediate  caufe  of  the 
deficiencies  of  action  of  fome  links  of  the  aflbciations  of  irrita- 
tive motions  ;  firft,  becaufe  the  trains  and  tribes  of  motions, 
which  compofe  thefe  links,  are  fo  widely  extended  as  to  embrace 
almoft  the  whole  animal  fyftem  ;  and  fecondly,  becaufe  when 
the  firft  link  of  an  aflbciated  train  of  actions  is  exerted  with  too 
great  energy,  the  fecond  link  by  reverfe  fympathy  may  be  affected 
with  torpor.  And  then  this  fecond  link  may  tranfmit,  as  it 
were,  this  torpor  to  a  third  link,  and  at  the  fame  time  regain  its 
own  energy  of  action  ;  and  it  is  poflible  this  third  link  may 
in  like  manner  tranfmit  its  torpor  to  a  fourth,  and  thus  regain 
its  own  natural  quantity  of  motion. 

I  (hall  endeavour  to  explain  this  by  an  example  taken  from 
fenfitive  aflbciated  motions,  as  the  origin  of  their  difturbed  ac- 
tions is  more  eafily  detected.  This  morning  1  faw  an  elderly 
perfon,  who  had  gradually  loft  all  the  teeth  in  his  upper  jaw, 
and  all  of  the  under  except  three  of  the  molares  ;  the  laft  of 
thefe  was  now  loofe,  and  occafionally  painful ;  the  fangs  of 
which  were  almoft  naked,  the  gums  being  much  wafted  both 
within  and  without  the  jaw.  He  is  a  man  of  attentive  obfer- 
vation,  and  aflured  me,  that  he  had  again  and  again  noticed, 
that,  when  a  pain  commenced  in  the  membranes  of  the  alveolar 
procefs  of  the  upper  jaw  oppofite  to  the  loofe  tooth  in  the  under 
one  (which  had  frequently  occurred  for  feveral  days  paft)  the 
pain  of  the  loofe  tooth  ceafed.  And  that,  when  the  pain  after- 
wards extended  to  the  ear  and  temple  on  that  fide,  the  pain  in 
the  membranes  of  the  upper  jaw  ceafed.  In  this  cafe  the  mem- 
branes of  the  alveolar  procefs  of  the  upper  jaw  became  torpid, 
and  confequehtly  painful,  by  their  reverfe  fympathy  with  the 

tOO 


400  DISEASES  CLASS  IV.  2.  1. 1* 

too  violent  actions  of  the  inflamed  membranes  of  the  loofe  tooth  5 
and  then  by  a  fecondary  fympathy  the  membranes  about  the 
car  and  temple  became  torpid,  and  painful  j  and  thofe  of  the 
alveolar  procels  of  the  upper  jaw  regained  their  natural  quanti- 
ty of  acHon,  and  ceafed  to  be  painful.  A  great  many  more  nice 
and  attentive  obfervations  are  wanted  to  elucidate  thefe  curious 
circumftances  of  affociation,  which  will  be  found  to  be  of  the 
Created  importance  in  the  cure  of  many  difeafes,  and  lead  us  to 
the  knowledge  of  fever. 

SPECIES. 

1.  Cutis  frigida  pranforum.     Chillnefs  after  dinner  frequently 
attends  weak  people,  or  thofe  who  have  been  exhaufted  by  exer- 
cife  ;  it  arifes  from  the  great  expenditure  of  the  fenforial  power 
on  the  organs  of  digeftion,  which  are   ftimulated  into  violent 
action  by  the  aliment;  and  the  veiTels  of  the  fkin,  which  are  af- 
fociated  with  them,  become  in  fome  meafure   torpid  by  reverfe 
fympathy ;  and  a  confequent  chillnefs  fucceeds  with  lefs  abforp- 
tion  of  atmofpheric  moifture.     See  the  fubfequent  article. 

2.  Pallor   urina  pranforum.     The   palenefs  of  urine  after  a 
full  meal  is  an  inftance  of  reverfe  aflbciation ;  where  the  fecond- 
ary part  of  a  train  of  aflbciate  motions  acts  with  lefs  energy  in 
confequence  of  the  greater  exertions  of  the  primary  part.     Af- 
ter dinner  theabforbent  vefTels  of  the  ftomach  and  interlines  are 
ftimulated  into  greater  action,  and  drink  up  the  newly  taken  al- 
iment;  while  thofe,  which  are  fpread   in  great  number,  on  the 
neck  of  the  bladder,  abforb  lefs  of  the  aqueous  part  of  the  urine 
than  ufual,  which  is  therefore  difcharged  in  a  more  dilute  ftate  5 
and  has  been  termed  crude  by  fome  medical  writers,  but  it  only 
indicates,  that  fo  great  a  proportion  of  the  fenforial  power  is  ex- 
pended on  digeftion  and  abforption  of  the  aliment,  that  other 
parts  of  the  fyftem  act  for  a  time  with  lefs  energy.  See  Clafs  IV. 
i.   i.  6* 

3.  Pallor  urin*  a  f rigor e  cutaneo.     There  is  a  temporary  dif- 
charge  of  pale  water,  and  a  diarrhoea,  induced  by  expofing  the 
[kin  to  the  cold  air  j  as  is  experienced  by  boys,  who  ftrip  them* 
felves  before  bathing.     In  this  cafe  the  mouths  of  the  cutaneous 
lymphatics  become  torpid  by  the  fubduction  of  their  accuftom- 
ed  degree  of  heat,  and  thofe  of  the  bladder  and  inteftines  be- 
come torpid  by  direct  fympathy ;  whence  lefs  of  the  thinner  part 
of  the  urinary  fecretion,  and  of  the  mucus  of  the  inteftines,  is 
reabforbed.     See  Se&.  XXIX.  4.   6.     This  effect  of  fuddenly 
tooling  the  (kin  by  the  afperfion  of  cold  water  has  been   ufed 
with  fuccefs  in  coftivencfs,  and  has  produced  evacuations,  when 

other 


CLASS  IV.  2.  i.  4.      OF  ASSOCIATION.  401 

other  means  have  failed.  When  young  infants  ate  afflicted 
with  griping  joined  with  coftivenefs,  I  have  fometimes  directed 
them  to  be  taken  out  of  a  warm  bed,  and  carried  about  for  i 
few  minutes  in  a  cool  room,  with  almoft  inftant  relief. 

4.  Palkr  ex  fgritudine.     When  ficknefs  of  ftomach  firft  oc- 
curs, a  palenefs  of  the  (kin  attends  it ;    which  is  owing  to  the 
aflbciation  or  catenation  between  the  capillaries  of  the  ftomach 
and  the  cutaneous  ones  ;  which  at  firft  act  by  direct  fympathy. 
But  in  a  ihort  time  there  commences  an  accumulation  of  the 
fenforial  power  of  aflbciation  in  the  cutaneous  capillaries  during 
their  ftate  of  inactivity,  and  then  the  ikin  begins  to  glow,  and 
fweats  break  out,  from  the  increafed  actions  of  the  cutaneous 
glands  or  capillaries,  which  is  now  in  reverfe  fympathy  with 
thofe  of  the  ftomach.     So  in  continued  fevers,  when  the  ftom- 
ach is  totally  torpid,  which  is  known  by  the  total  averfion  to 
folid  food,  the  cutaneous  capillaries  are  by  reverfe  fympathy  in 
a  perpetual  ftate  of  increafed  activity,  as  appears  from  the  heat 
of  the  fkin. 

5.  Dyfpnaea  a  bafaeo  frigido.     The  difficulty  of  breathing  on 
going  up  to  the  middle  in  cold  water  is  owing  to  the  irritative 
aflbciation  or  catenation  of  the  action  of  the  extreme  veflels  of 
the  lungs  with  thofe  of  the  fkin.     So  that  when  the  latter  are 
rendered  torpid  or  inactive  by  the  application  of  fudden  cold, 
the  former  become  inactive  at  the  fame  time,  and  retard  the 
circulation  of  the  blood  through  the  lungs,  for  this  difficulty  of 
breathing  cannot  be  owing  to  the  preflure  of  the  water  imped- 
ing the  circulation  downwards,  as  it  happens  equally  by  a  cold 
(hower-bath,  and  is  foon   conquered  by  habitual  immerfions. 
The  capillaries  of  the  fkin  are  rendered  torpid  by  the  fubduc- 
tion  of  the  ftimulus  of  heat,  and  by  the  consequent  diminutions 
of  the  fenforial  power  of  irritation.    The  capillaries  of  the  lungs 
are  rendered  torpid  by  the  diminution  of  the  fenforial  power  of 
aflbciation,  which  is  now  excited  in  lefs  quantity  by  the  leflen- 
ed  actions  of  the  capillaries  of  the  {kin,  with  which  they  are 
catenated.     So  that  at  this  time  both  the  cutaneous  and  pulmo- 
nary capillaries  are  principally  actuated,  as  far  as  they  have  any 
action,  by  the  ftimulus  of  the  blood.     But  in  a  fhort  time  the 
fenforial  powers  of  irritation,  and  of  aflbciation,  become  accu- 
mulated, and  very  energetic  action  of  both  thefe  membranes 
fucceeds.     Which  thus  refemble  the  cold  and  hot  fit  of  an  in- 
termittent fever. 

6.  Dyjpepfta  a  pedibus  frigidis.  When  the  feet  are  long  cold, 
as  in  riding  in  cold  and  wet  weather,  fome  people  are  very- 
liable  to  indigeftion  and  confequent  heart-burn.  The  irritative 
motions  of  the  ftomach  become  torpid,  and  do  their  office  of  di- 

VOL.  IT,  I^D  d  geftibn 


402  DISEASES  CLASS  IV.  2.  i.  7, 

geftion  imperfe&ly,  in  confequence  of  their  aflbciation  with  the 
torpid  motions  of  the  veflels  of  the  extremities.  Fear,  as  it  pro- 
duces palenefs  and  torpidity  of  the  fkin,  frequently  occafions  tem- 
porary indigeftion  in  confequence  of  this  aflbciation  of  the  vef- 
fels  of  the  {kin  with  thofe  of  the  ftomach  ;  as  riding  in  very  bad 
roads  will  give  flatulency  and  indigeftion  to  timorous  people. 

A  fhort  expofure  to  cold  air  increafes  digeftion,  which  is  then 
owing  to  the  reverfe  fympathy  between  the  capillary  veflels  of 
the  {kin,  and  of  the  ftomach.  Hence  when  the  body  is  expofed 
to  cold  air,  within  certain  limits  of  time  and  quantity,  a  reverfe 
fympathy  of  the  ftomach  and  the  {kin  firft  occurs,  and  after- 
wards a  direcl:  fympathy.  In  the  former  cafe  the  expendi- 
ture of  fenforial  power  by  the  (kin  being  leflened,  but  not  its 
production  in  the  brain  ;  the  fecond  link  of  the  aflbciation,  viz. 
the  ftomach,  acquires  a  greater  (hare  of  it.  In  the  latter  cafe, 
by  the  continuation  of  the  deficient  ftimulus  of  heat,  the  torpor 
becomes  extended  to  the  brain  itfelf,  or  to  the  trunks  of  the 
nerves  ;  and  univerfal  inactivity  follows. 

7.  TuJ/is  a  pedibus  frigidis.     On  {landing  with  the  feet  in 
thawing  fnow,  many  people  are  liable  to  inceflant  coughing. 
From  the  torpidity  of  the  abforbent  veflels  of  the  lungs,  in  con- 
fequence of  their  irritative  aflbciatiens  with  thofe  of  the  (kin, 
they  ceafe  to  abforb  the  faline  part  of  the  fecreted  mucus ;  and 
a  cough  is  thus  induced  by  the  irritation  of  this  faline  fecretion ; 
which  is  fimilar  to  that  from  the  noftrils  in  frofty  weather,  but 
differs  in  refpedl:  to  its  immediate  caufe  ;  the  former  being  from 
aflbciation  with  a  diftant  part,  and  the  latter  from  defecl:  of 
the  ftimulus  of  heat  on  the  noftrils  themfelves.     See  Catarrhus 
frigidus,  Clafs  I.  2.  3.  3. 

8.  Tuffls  hepatica.     The  cough  of  inebriates,  which  attends 
the  enlargement  of  the  liver,  or  a  chronical  inflammation  of  its 
upper  membrane,  is  fuppofed  to  be  produced  by  the  inconveni- 
ence the  diaphragm  fuflers  from  the  compreflion  or  heat  of  the 
liver.     It  differs  howevex  eflentially  from  that  attending  hepati- 
tis, from  its  not  being  accompanied  with  fever.     And  is  per- 
haps rather  owing  to  irritative  aflbciation,  or  reverfe  fympathy, 
between  the  lungs  and  the  liver.     As  occurs  in  flieep,  which 
are  liable  to  a  perpetual  dry  cough,  when  the  fluke-worm  is  prey- 
ing on  the  fubftance  of  their  livers.     See  Clafs  II.  i.  I.  5. 

M.  M.  From  half  a  grain  to  a  grain  of  opium  twice  a  day. 
A  drachm  of  mercurial  ointment  rubbed  on  the  region  of  the 
liver  every  night  for  eight  or  ten  times. 

9.  Tuffis  arthritica.     Gout-cough.     I  have  feen  a  cough, 
which  twice  recurred  at  a  few  years  diftance  in  the  fame  per- 
!•!!,  during  his  ffts  of  tke  gout,  with  fuch  pertinacity  and  vio- 
lence 


CLASS  IV.  2. 1. 10.     OF  ASSOCIATION.  403 

lence  as  to  refift  venefecfion,  opiates,  bark,  blifters,  mucilages, 
and  all  the  ufual  methods  employed  in  coughs.  It  was  for  a 
time  fuppofed  to  be  the  hooping-cough,  from  the  violence  of  the 
action  of  coughing  ;  it  continued  two  or  three  weeks,  the  pa- 
tient never  being  able  to  fleep  more  than  a  few  minutes  at  once 
during  the  whole  time,  and  being  propped  up  in  bed  with  pil- 
lows night  and  day. 

As  no  fever  attended  this  violent  cough,  and  but  little  expec- 
toration, and  that  of  a  thin  and  frothy  kind,  I  fufpected  the 
membrane  of  the  lungs  to  be  rather  torpid  than  inflamed,  and 
that  the  faline  part  of  the  mucus  not  being  abforbed  ftimulated 
them  into  perpetual  exertion.  And  laftly,  that  though  the 
lungs  are  not  fenfible  to  cold  and  heat,  and  probably  therefore 
lefs  mobile,  yet,  as  they  are  neverthelefs  liable  to  confent  with 
the  torpor  of  cold  feet,  as  defcribed  in  Species  6  of  this  Genus, 
I  fufpected  this  torpor  of  the  lungs  to  fucceed  the  gout  in  the 
feet,  or  to  aft  a  vicarious  part  for  them. 

10.  Vertigo  rotatoria.  In  the  vertigo  from  circumgyration 
the  irritative  motions  of  vifion  are  increafed  ;  which  is  evinced 
from  the  pleafure  that  children  receive  on  being  rocked  in  a 
cradle,  or  by  fwinging  on  a  rope.  For  whenever  fenfation  arif- 
es  from  the  production  of  irritative  motion  with  lefs  energy 
than  natural,  it  is  of  the  difagreeable  kind,  as  from  cold  or  hun- 
ger ;  but  when  it  arifes  from  their  production  with  greater  en- 
ergy than  natural,  if  it  be  confined  within  certain  limits,  it  is  of 
the  pleafurable  kind,  as  by  warmth  or  wine.  With  thefe  in- 
creafed irritative  motions  of  vifion,  I  fuppofe  thofe  of  the  ftom- 
ach  are  performed  with  greater  energy  by  direct  fympathy ;  but 
when  the  rotatory  motions,  which  produce  this  agreeable  verti- 
go, are  continued  too  long,  or  are  too  violent,  ficknefs  of  the 
llomach  follows  5  which  is  owing  to  the  decreafed  action  of  that 
organ  from  its  reverfe  fympathy  with  the  increafed  actions  of 
the  organ  of  vifion.  For  the  expenditure  of  fenforial  power  by 
the  organ  of  vifion  is  always  very  great,  as  appears  by  the  fize 
of  the  optic  nerves  ;  and  is  now  fo  much  increafed  as  to  deprive 
the  next  link  of  aiTociation  of  its  due  (hare.  As  mentioned  in 
Species  6  of  this  Genus. 

In  the  fame  manner  the  undulations  of  water,  or  the  motions 
of  a  fhip,  at  firft  give  pleafure  by  increafing  the  irritative  mo- 
tions belonging  to  the  fenfe  of  vifion  ;  but  produce  ficknefs  at 
length  by  expending  on  one  part  of  the  alfociated  train  of  irri- 
tative actions  too  much  of  that  fenforial  power,  which  ufually 
ferved  the  whole  of  it ;  whence  ibme  other  parts  of  the  train  ac- 
quire too  little  of  it,  and  perform  their  actions  in  confequence  too 
feebly,  and  thence  become  attended  with  difagreeable  fenfation, 

It 


DISEASES          CLASS  IV.  2.  i.  ic. 

It  mufl  alfo  be  obferved,  that  when  the  irritative  motions  are 
{timulated  into  unufual  a&ion,  as  in  inebriation,  they  become 
fucceeded  by  fenfation,  either  of  the  pleafurable  or  painful  kind  5 
and  thus  a  new  link  is  introduced  between  the  irritative  mo- 
tions thus  excited,  and  thofe  which  ufed  to  fucceed  them ; 
whence  the  aflbciation  is  either  diflevered  or  much  weakened, 
and  thus  the  vomiting  in  fea-ficknefs  occurs  from  the  defect  of 
the  power  of  aflbciation,  rather  than  from  the  general  deficiency 
of  fenforial  power. 

When  a  blind  man  turns  round,  or  when  one,  who  is  not 
blind,  revolves  in  the  dark,  a  vertigo  is  produced  belonging  to 
the  fenfe  of  touch.  A  blind  man  balances  himfelf  by  the  fenfe 
of  touch,  which  being  a  lefs  perfect  means  of  determining  fmall 
quantities  of  deviation  from  the  perpendicular,  occafions  him  to 
walk  mpre  carefully  upright  than  thofe,  who  balance  themielves 
by  vifion.  When  he  revolves,  the  irritative  aflbciations  of  the 
mufcular  motions,  which  were  ufed  to  preferve  his  perpendicu- 
larity, become  difordered  by  their  new  modes  of  fucceffive  ex- 
ertion ;  and  he  begins  to  fall.  For  his  feet  now  touch  the  floor 
in  manners  or  directions  different  from  thofe  they  have  been  ac- 
cuftomed  to  ;  and  in  confequence  he  judges  lefs  perfectly  of  the 
lituation  of  the  parts  of  the  floor  in  refpeft  to  that  of  his  own 
body,  and  thus  lofes  his  perpendicular  attitude.  This  may  be 
illuftrated  by  the  curious  experiment  of  crofiing  one  finger  over 
the  next  to  it,  and  feeling  a  nut  or  bullet  with  the  ends  of  them. 
When,  if  the  eyes  be  clofed,  the  nut  or  bullet  appears  to  be  two, 
from  the  deception  of  the  fenfe  of  touch. 

In  this  vertigo  from  gyration,  both  of  the  fenfe  of  fight,  and 
pf  the  fenfe  of  touch,  the  primary  link  of  the  aflbciated  irritative 
motions  is  increafed  in  energy,  and  the  fecondary  ones  are  in- 
creafed  at  firfl  by  direct  fympathy ;  but  after  a  time  they  become 
decreafed  by  reverfe  fympathy  with  the  primary  link,  owing  to 
the  cxhauftion  of  fenforial  power  in  general,  or  to  the  power  of 
Aflbciation  in  particular ;  becaufe  in  the  laft  cafe,  either  pleafur- 
able or  painful  fenfation  has  been  introduced  between  the  link* 
of  a  train  of  irritative  motions,  and  has  diflevered,  or  much  en- 
feebled them. 

Dr.  Smyth,  in  his  Eflay  on  Swinging  in  Pulmonary  Confump- 
tion,  has  obferved,  that  fwinging  makes  the  pulfe  flower.  Dr. 
Ewart  of  Bath  confirmed  this  obfervation  both  on  himfelf  and 
on  Col.  Cathcart,  who  was  then  heclic,  and  that  even  on  fhip- 
board,  where  fome  degree  of  vertigo  might  be  fuppofed  previ- 
oufly  to  exift.  Dr.  Currie  of  Liverpool  not  only  confirmed  this 
obfervation  frequently  on  himfelf,  when  he  was  alfo  phthifical, 
but  found  that  equitation  had  a  fimilar  effeft  on  him,  uniform- 


CLASS  IV.  2.1.10.       OF  ASSOCIATION.  405 

ly  retarding  his  pulfe.  This  curious  circumftance  cannot  arife 
from  the  general  effect  of  exercife,  or  fatigue,  as  in  thofe  cafes 
the  pulfe  becomes  weaker  and  quicker ;  it  muft  therefore  be  af- 
cribed  to  a  degree  of  vertigo,  which  attends  all  thofe  modes  of 
motion,  which  we  are  not  perpetually  accuftomed  to. 

Dr.  Currie  has  further  obferved,  that  "  in  cafes  of  great  de- 
bility the  voluntary  mufcular  exertion  requifite  in  a  fwing  pro- 
duces wearinefs,  that  is,  increafes  debility ;  and  that  in  fuch  in- 
flates he  had  frequently  noticed,  that  the  diminution  of  the  fre- 
quency of  the  pulfe  did  not  take  place,  but  the  contrary."  Thefc 
circumftances  may  thus  be  accounted  for. 

The  links  of  aflbciation,  which  are  effected  in  the  vertigo  oc- 
cafioned  by  unufual  motion,  are  the  irritative  motions  of  the 
fenfe  of  vifion,  thofe  of  the  ftomach,  and  thofe  of  the  heart  and 
arteries.  When  the  irritative  ideas  of  vifion  are  exerted  with 
greater  energy  at  the  beginning  of  vertigo,  a  degree  of  fenfation 
is  excited,  which  is  of  the  pleafurable  kind,  as  above  mentioned  5 
whence  the  aifociated  trains  of  irritative  motions  of  the  ftomach, 
and  hean,  and  arteries,  act  at  firft  with  greater  energy,  both  by 
direct  fympathy,  and  by  the  additional  fenforial  power  of  fenfa- 
tion. Whence  the  pulfe  of  a  confumptive  patient  becomes  ftrong- 
er  and  confequently  flower. 

But  if  this  vertigo  becomes  much  greater  in  degree  or  dura- 
tion, the  firft  link  of  this  train  of  aflbciated  irritative  motions 
expends  too  much  of  the  fenforial  power,  which  was  ufually  em- 
ployed on  the  whole  train  ;  and  the  motions  of  the  ftomach  be- 
come in  confequence  exerted  with  lefs  energy.  This  appears, 
becaufe  in  this  degree  of  vertigo  fickuefs  fupervenes,  as  in  fea- 
(icknefs,  which  has  been  (hewn  to  be  owing  to  lefs  energetic  ac- 
tion of  the  ftomach.  And  the  motions  of  the  heart  and  arteries 
then  become  weaker,  and  in  confequence  more  frequent,  by  their 
direct  fympathy  with  the  lelfened  actions  of  the  ftomach.  See 
Supplement,  I.  12.  and  Clafs  II.  i.  6.  7.  The  general  weak- 
nefs  from  fatigue  is  owing  to  a  fimilar  caufe,  that  is,  to  the  too 
great  expenditure  of  fenforial  power  in  the  increafed  actions  of 
one  part  of  the  fyftem,  and  the  confequent  deficiency  of  it  in 
other  parts,  or  in  the  whole. 

The  abatement  of  the  heat  of  the  (kin  in  hectic  fever  by 
fwinging,  is  not  only  owing  to  the  increafed  ventilation  of  cool 
air,  but  to  the  reverfe  fympathy  of  the  motions  of  the  cutaneous 
capillaries  with  thofe  of  the  heart  and  arteries ;  which  occurs  in 
all  fevers  with  arterial  debility,  and  a  hot  or  dry  fkin.  Hence 
during  moderate  fwinging  the  action  of  the  heart  and  arteries 
becomes  ftronger  and  flower,  and  the  action  of  the  capillaries, 
which  was  before  too  great,  as  appeared  by  the  heat  of  the  flcin, 

is 


406  DISEASES  CLASS  IV.  2.1.11. 

is  now  leffened  by  their  reverfe  fympathy  with  that  of  the  hearfc 
and  arteries.  See  Supplement,  I.  8. 

1 1 .  Fertigo  vifualis.  Vifual  vertigo.  The  vertigo  rotatoria 
defcribed  above,  was  induced  by  the  rotation  or  undulation  of 
external  objects,  and  was  attended  with  increafed  action  of  the 
primary  link  of  the  ailbciated  motions  belonging  to  vifion,  and 
with  confequent  pleafure.  The  vertigo  vifualis  is  owing  to  lefs 
perfect  vifion,  and  is  not  accompanied  with  pleafurable  fenfa- 
tion.  This  frequently  occurs  in  ftrokes  of  the  palfy,  and  is  then 
fucceeded  by  vomiting ;  it  fometimes  precedes  epileptic  fits, 
and  often  attends  thofe,  whofe  fight  begins  to  be  impaired  by 
age. 

In  this  vertigo  the  irritative  ideas  of  the  apparent  motions  of 
objects  are  lefs  diftinct,  and  on  that  account  are  not  fucceeded 
by  their  ufual  irritative  afibciations  of  motion  ;  but  excite  our 
attention.  Whence  the  objects  appear  to  librate  or  circulate 
according  to  the  motions  of  our  heads,  which  is  called  dizzinefs  ; 
and  we  lofe  the  means  of  balancing  ourtelves,  or  preferving  our 
perpendicularity,  by  viiion.  So  that  in  this  vertigo  the  motions 
of  the  aflbciated  organs  are  decreafed  by  direct  fympathy  with 
their  primary  link  of  irritation  ;  as  in  the  preceding  cafe  of  fea- 
(icknefs  they  are  decreafed  by  reverfe  fympathy. 

When  vertigo  affects  people  about  fifty  years  of  age,  their 
fight  has  generally  been  fuddenly  impaired  ;  and  from  their  lefs 
accurate  vifion  they  do  not  foon  enough  perceive  the  apparent 
motions  of  objects ;  like  a  perfon  in  a  room,  the  walls  of  which 
are  ftained  with  the  uniform  figures  of  lozenges,  explained  in 
Sect.  XX.  i.  This  is  generally  afcribed  to  indigeftion  ;  but  it 
ceafes  fpontaneoufly,  as  the  patient  acquires  the  habit  of  balanc- 
ing himfelf  by  lefs  diftinct  objects. 

A  gentleman  about  50  was  feized  with  an  uncommon  degree 
of  vertigo,  fo  as  to  fall  on  the  ground,  and  not  to  be  able  to  turn 
his  head,  as  he  fat  up  either  in  his  chair  or  in  his  bed,  and  this 
continued  eight  or  ten  weeks.  As  he  had  many  decayed  teeth 
in  his  mouth,  and  the  vertigo  was  preceded  and  fometimes  ac- 
companied by  pains  on  one  fide  of  his  head,  the  difeafe  of  a 
tooth  was  fufpected  to  be  the  caufe.  And  as  his  timidity  was 
too  great  to  admit  the  extraction  of  thofe  which  were  de- 
cayed ;  after  the  trial  of  cupping  repeatedly,  fomentations  on 
his  head,  repeated  blifters,  with  valerian,  Peruvian  bark,  mufk, 
opium,  and  variety  of  other  medicines  ;  mercurials  were  ufed, 
both  externally  and  internally,  with  defign  to  inflame  the  mem- 
branes of  the  teeth,  and  by  that  means  to  prevent  the  torpor  of 
the  action  of  the  membranes  about  the  temple,  and  parietal  bone; 
which  are  catenated  with  the  membranes  of  the  teeth  by  irrita-- 

tive 


CLASS  IV.  2.  1. 12.      OF  ASSOCIATION.  407 

tive  aflbciation,  but  not  by  fenfitive  aflbciation.  The  event  was, 
that  as  foon  as  the  gums  became  fore  with  a  flight  ptyalifm,  the 
pains  about  the  head  and  vertigo  gradually  diminiflied,and  during 
the  forenefs  of  his  gums  entirely  ceafed  ;  but  I  believe  recurred 
afterwards,  though  in  lefs  degree. 

The  idea  of  inflaming  the  membranes  of  the  teeth  to  pro- 
duce increafed  fenfation  in  them,  and  thus  to  prevent  their 
irritative  connexion  with  thofe  of  the  cranium,  was  taken  from 
the  treatment  of  trifmus,  or  locked  jaw,  by  endeavouring  to  in- 
flame the  injured  tendon ;  which  is  faid  to  prevent  or  to  remove 
the  fpafm  of  the  mufcles  of  the  jaw.  See  Clafs  III.  i.  I.  13. 
and  15. 

M.  M.  Emetics.  Blifters.  Ifiues' about  the  head.  Extrac- 
tion of  decayed  teeth.'  Slight  falivation.  Sorbentia.  Incitantia. 
Galvanifm. 

A  lady  was  fuddenly  feized  with  violent  vertigo,  fo  as  to  pre- 
vent her  from  walking  fafely  acrofs  the  room,  this  was  attended 
with  confiderable  diminution  of  fight ;  and  after  various  evacua- 
tions, and  other  medicines,  had  been  tried  without  cure,  Mr. 
Volta's  galvanic  pillar  was  ufed,  confiding  of  about  30  plates  of 
filver,  the  diameter  of  about  one  inch  and  half,  and  as  many 
zinc  plates,  with  interpofed  circles  of  cloth  moiftened  with  brine. 
A  wire  connected  with  each  end  of  this  pillar  was  approached 
repeatedly  to  her  temples,  which  were  previoufly  moiftened  with 
brine,  and  100  galvanic  fhocks  were  daily  patted  through  the 
optic  nerves,  which  foon  appeared  to  be  of  great  advantage,  and 
(he  foon  recovered,  both  from  the  vertigo  and  dimnefs  of  fight. 
12.  Vertigo  ebriofa.  Vertigo  from  intoxicatign  is  owing  to 
the  aflbciation  of  the  irritative  ideas  of  vifion  with  the  irritative 
motions  of  the  ftomach.  Whence  when  thefe  latter  become 
much  increafed  by  the  immoderate  ftimulus  of  wine,  the  irrita- 
tive motions  of  the  retina  are  produced  with  lefs  energy  by  re- 
verfe  fympathy,  and  become  at  the  fame  time  fucceeded  by  fen- 
fation in  confequence  of  their  decreafed  action.  See  Seel.  XXI. 
3.  and  XXXV.  1.2.  So  converfely  when  the  irritative  mo- 
tions of  vifion  are  increafed  by  turning  round,  or  by  our  unac- 
cuftomed  agitation  at  fea,  thofe  of  the  ftomach  become  inverted 
by  reverfe  fympathy,  and  are  attended  in  confequence  with  difa- 
greeable  fenfation.  Which  decreafed  action  of  the  ftomach  is 
in  confequence  of  the  increafed  expenditure  of  the  fenforial 
power  on  the  irritative  ideas  of  vifion,  as  explained  in  Vertigo 
rotatoria. 

Whence  though  a  certain  quantity  of  vinous  fpirit  flimulutes 
the  whole  fyftem  into  increafed  action,  and  perhaps  even  in- 
creafes  the  fecretion  of  fenforial  power  in  the  brain  •,  yet  .is  foon 

as 


4o8  DISEASES          CLASS  IV.  2.  i.  13, 

as  any  degree  of  vertigo  is  produced,  it  is  a  proof,  that  by  the 
too  great  expenditure  of  fenforial  power  by  the  ftomach,  and  its 
neareft  afibciated  motions,  the  morediftant  ones,  as  thofe  ofvif- 
km,  become  imperfectly  exerted.  From  hence  may  be  deduc- 
ed the  necefTny  of  exhibiting  wine  in  fevers  with  v/eak  pulfe 
in  only  appropriated  Quantity  ;  becaufe  if  the  leaft  intoxication 
be  induced,  fome  part  of  the  iyftem  muft  act  more  feebly  from 
the  unnecefTary  expenditure  of  fenforial  power. 

13.  Vertigo  febriculofa.     Vertigo   in  fevers  either  proceeds 
from  the  general  deficiency  of  fenforial  power  belonging  to  the 
irritative  aflbciations,  or  to  a  greater  expenditure  of  it  on  fome 
links   of  the  trams   and  tribes  of  afTociated  irritative  motions. 
There  is  however  a  (lighter  vertigo  attending  all  people,  who 
have  been  long  confined  in  bed,  on  their  firft  riling ;  owing  to 
their  having  been  fo  long  unufed  to  the  apparent  motions  of  ob- 
jects in  their  erect  pofture,  or  as  they  pafs  by  them,  that  they 
have  loft  in  part  the  habit  of  balancing  themfelves  by  them. 

14.  Vertigo  cerebrcfa.     Vertigo  from   injuries  of  the  brain, 
either  from  external  violence  or  which  attend  paralytic  attacks, 
are  owing   to  the  general   deficiency  of  fenforial  power.     In 
thefe  dirtrefsful  fituations  the  vital  motions,  or  thofe  immediate- 
ly neceffary  to  life,  claim  their  fhare  of  fenforial  power   in  the 
iirfl  place,  otherwife  the  patient  mull  die  5  and  thofe  motions, 
which  are  lefs  neceflary,  feel  a  deficiency  of  it,  as  thefe  of  the 
organs  of  fenfe  and  mufcles  ;  which  conftitute  vertigo  ;  and  laft- 
ly  the  voluntary  motions,  which  are  (lill  lefs  immediately  necef- 
fary to  life,  are  frequently  partially  deftroyed,   as  in  palfy  j  or 
totally,  a$  in  apoplexy. 

15.  Murmur  aurium  vertiginofum.     The  vertiginous  murmur 
in  the  ears,  or  noife  in  the  head,  is  compared  to  the  undulations 
of  the  found  of  bells,  or  to  the  humming  of  bees.     It  frequent- 
ly attends  people  about  60  years  of  age  •,  and  like  the  vifual  ver- 
tigo defcribed  above  is  owing  to  our  hearing  lefs  perfectly  from 
the  gradual  inirritability  of  the  organ  on  the  approach  of  age ; 
and  the  difagreeable  fenfation  of  noife  attending  it  is  owing  to 
the  lefs  energetic  action  of  thefe  irritative  motions  ;  which  not 
being  fufficiently  diftinct  to  excite  their  ufual  aflbciations  become 
fucceeded  by   our  attention,  like  the  indiftinct  view  of  the  ap- 
parent motions  of  objects  mentioned  in  vertigo  vifualis.     This 
may  be  better   und>*  flood   from    confidering   the    ufe,  which 
blind  men  make  of  thefe  irritative   founds,  which  they  have 
taught  themfelves  to  attend  to,  but  which  efcape  the  notice  of 
others.     The   late    blind  Juftice  Fielding  walked  for  the  firft 
time  into  my  room,  when  he  once  vifited   me,  and  after  fpeak- 
)ng  a  few  words  faid,  "  This  room  is  about  22  feet  long,   18 

wide, 


CLASS  IV.  2.1.16.       OF  ASSOCIATION.  409 

wide,  and  12  high  ;"  all  which  he  guefled  by  the  ear  with  great 
accuracy.  Now  if  thefe  irritative  founds  from  the  partial  lofs 
of  hearing  do  not  correfpond  with  the  fize  or  ufual  echoes  of 
the  places,  where  we  are  -,  their  catenation  with  other  irritative 
ideas,  as  thofe  of  vifion,  becomes  diflevered  or  difturbed  ;  and  we 
attend  to  them  in  confequence,  which  I  think  unravels  this  in- 
tricate circumftance  of  noifes  being  always  heard  in  the  head* 
when  the  fenfe  of  hearing  begins  to  be  impaired,  from  whatever 
caufe  it  occurs. 

This  ringing  in  the  ears  alfo  attends  the  vertigo  from  intoxi- 
cation ;  for  the  irritative  ideas  of  found  are  then  more  weakly- 
excited  in  confequence  of  the  deficiency  of  the  fenforial  power 
of  aflbciation.  As  is  known  by  this  alfo  being  attended  with 
difagreeable  fenfation,  and  by  its  accompanying  other  difeafes  of 
debility,  as  ftrokes  on  the  head,  fainting  fits,  and  paralytic  feiz- 
ures.  For  in  this  vertigo  from  intoxication  fo  much  fenforial 
power  in  general  is  expended  on  the  increafed  actions  of  the 
ftomach,and  its  neareft  connections,  as  the  capillaries  of  the  {kin  ; 
that  there  is  a  deficiency  for  the  purpofes  of  the  other  irritative 
aflbciations  of  motions  ufually  connected  with  it.  This  auditory- 
vertigo  attends  both  the  rotatory  and  the  vifual  vertigo  above- 
mentioned  ;  in  the  former  it  is  introduced  by  reverfe  fympathy$ 
that  is,  by  the  diminution  of  fenforial  power ;  too  great  a 
quantity  of  it  being  expended  on  the  increafed  irritative  motions 
of  vifion  ;  in  the  latter  it  is  produced  either  by  the  fame  caufes 
which  produce  the  vifual  vertigo,  or  by  direcl:  fympathy  with  it., 
See  Sea.  XX.  7. 

M.  M.  Stimulate  the  internal  ear  by  ether,  or  with  eflential 
oil  diluted  with  exprefled  oil,  or  with  a  folution  of  opium  in  wine, 
or  in  water.  Or  with  fait  and  water.  Apply  a  cupping  glafs 
over  the  ear.  Seel.  2.  5.  6.  Galvanic  (hocks  through  the  tem- 
ples. See  IV.  2.  i.  n. 

1 6.  TacliiS)  gttftttSy  olfaEius  vertiginofi.  Vertiginous  touch, 
talte,  and  fmell.  In  the  vertigo  of  intoxication,  when  the  patient 
lies  down  in  bed,  it  fometimes  happens  even  in  the  dark,  that 
the  bed  feems  to  librate  under  him,  and  he  is  afraid  of  falling 
out  of  it.  The  fame  occurs  to  people,  who  are  fea-fick,  even 
when  they  lie  down  in  the  dark.  In  thefe  the  irritative  motions 
of  the  nerves  of  touch,  or  irritative  tangible  ideas,  are  performed 
with  lefs  energy,  in  one  cafe  by  reverfe  fympathy  with  the  ftom- 
ach,  in  the  other  by  reverfe  fympathy  with  the  nerves  of  vifion, 
and  in  confequence  become  attended  with  fenfation,  and  pro- 
duce the  fear  of  falling  by  other  afibciations. 

A  vertigo  of  the  fenfe  of  touch  may  be  produced,  if  any  one 
turns  round  for  a  time  with  his  eyes  (hut,  and  fuddenly  flops 

VOL.  II.  EEC  without 


410  DISEASES          CLASS  IV.  4.  1. 17. 

without  opening  them  ;  for  he  will  for  a  time  feem  to  be  ftill 
going  forwards ;  which  is  difficult  to  explain.  See  Sect.  XX.  6. 
In  the  beginning  of  fome  fevers,  along  with  inceflant  vomit- 
ing, the  patients  complain  of  difagreeable  taftes  in  their  mouth, 
and  difagreeable  odours  *,  which  are  to  be  afcribed  to  the  gen- 
eral debility  of  the  great  trains,  and  tribes  of  affbciated  and  irrita- 
tive motions,  and  to  be  explained  from  their  direct  fympathy 
with  the  decreafed  action  of  a  fick  ftomach ;  or  from  the  lefs 
fecretion  of  fenforial  power  in  the  brain.  Thefe  organs  of  fenfe 
are  conftantly  ftimulated  into  action  by  the  faliva  or  by  the  air ; 
hence,  like  the  fenfe  of  hunger,  when  they  are  torpid  from  want 
of  ftimulus,  or  from  want  of  fenforial  power,  pain  or  difagreea- 
ble fenfation  enfues,  as  of  hunger,  or  faintneis,  or  ficknefs  in 
one  cafe  ;  and  the  ideas  of  bad  taftes  or  odours  in  the  other. 
This  accords  with  the  laws  of  caufation,  Sect.  IV.  5. 

17.  Pulfus  mollis  in  vomitione.     The  foftnefs  of  the  pulfe  in 
the  act  of  vomiting  is  caufed  by  direct  affociation  between  the 
heart  and  the  ftomach  ;  as  explained  in  Sect.  XXV.  17.  A  great 
flownefs  of  the  pulfation  of  the  heart  fometimes  attends  ficknefs, 
and  even  with  intermifiions  of  it,  as  in  the  exhibition  of  too  great 
a  dofe  of  digitalis. 

1 8.  Pulfus  intermittent  a  ventricule.     When  the  pulfe  firft  be- 
gins to  intermit,  it  is  common  for  the  patient  to  bring  up  a  lit- 
tle air  from  his  ftomach  ;  which  if  he   accomplifhes  before  the 
intermiffion  occurs,  always  prevents  it  5  whence  that  this  debil- 
ity of  the  heart  is  owing  to  the  direct  aflbciation  of  its  motions 
with  thofe  of  the  ftomach  is  well  evinced.     See  Sect.  XXV.  17. 

I  this  morning  faw  Mr. ,  who  has  long  had  at  times  an 

unequal  pulfe,  with  indigeftion  and  flatulency,  and  occafional 
afthma ;  he  was  feized  two  days  ago  with  diarrhoea,  and  this 
morning  with  ficknefs,  and  his  pulfe  was  every  way  unequal. 
After  an  emetic  his  pulfe  ftill  continued  very  intermittent  and 
unequal.  He  then  took  fome  breakfaft  of  toaft  and  butter,  and 
tea,  and  to  my  great  furprife  his  pulfe  became  immediately  per- 
fectly regular,  about  100  in  a  minute,  and  not  weak,  by  this 
ftimulus  on  his  ftomach. 

A  perfon,  who  for  many  years  had  had  a  frequent  intermif- 
fion  of  his  pulfe,  and  occaiional  palpitation  of  his  heart,  was  re- 
lieved from  them  both  for  a  time  by  taking  about  four  drops  of 
a  faturated  folution  of  arfenic  three  or  four  times  a  day  for  three 
or  four  days.  As  this  intermiflion  of  the  pulfe  is  occafioned  by 
the  direct  affbciation  of  the  motions  of  the  heart  with  thofe  of 
the  ftomach,  the  indication  of  cure  muft  be  to  ftrengthen  the  ac- 
tion of  the  ftomach  by  the  bark.  Spice.  Moderate  quantities 

of 


CLASS  IV.  2.  1. 19.       OF  ASSOCIATION.  411 

of  wine.  A  blifter.  Half  a  grain  of  opium  twice  a  day.  So- 
lution of  arfenic  ? 

19.  Febris  inirritativa.  Inirritative  fever  defcribed  in  Clafs 
I.  2.  i.  i.  belongs  to  this  place,  as  it  confifts  of  difordered  trains 
and  tribes  of  aflbciated  irritative  motions,  with  leflened  actions 
of  the  aflbciated  organs.  In  this  fever  the  pulfations  of  the 
heart  and  arteries  are  weakened  or  leflened,  not  only  in  the 
cold  paroxyfm,  as  in  the  irritative  fever,  but  alfo  in  the 
hot  paroxyfm.  The  capillary  arteries  or  glands  have  their  ac- 
tions neverthelefs  increased  after  the  firft  cold  fit,  as  appears  by 
the  greater  production  of  heat,  and  the  glow  of  arterial  blood  in 
the  cutaneous  veflels  ;  and  laftly,  the  actton  of  the  fhomach  is 
much  impaired  or  deftroyed,  as  appears  by  the  total  want  of  ap- 
petite to  folid  food.  Whence  it  would  feem,  that  the  torpid 
motions  of  the  ftomach,  whatever  may  occafion  them,  are  a 
very  frequent  caufe  of  continued  fever  with  weak  pulfe  ;  and 
that  thefe  torpid  motions  of  the  ftomach  do  not  fufficiently  ex- 
cite the  fenforial  power  of  aflbciation,  which  contributes  in 
health  to  actuate  the  heart  and  arteries  along  with  the  irritation 
produced  by  the  ftimulus  of  the  blood ;  and  hence  the  actions 
of  thefe  organs  are  weaker.  And  laftly,  that  the  accumulation 
the  fenforial  power  of  aflbciation,  which  ought  to  be  expended 
on  the  motions  of  the  heart  and  arteries,  becomes  now  exerted 
on  the  cutaneous  and  pulmonary  capillaries.  See  Supplement 
I.  8.  and  Sea.  XXXV.  i.  i.  and  XXXIII.  2.  10. 

I  have  dwelt  longer  on  the  vertiginous  difeafes  in  this  genus, 
both  becaufe  of  their  great  intricacy,  and  becaufe  they  feem  to 
open  a  road  to  the  knowledge  of  fever,  which  confifts  of  aflbciat- 
ed trains  and  tribes  of  irritative  or  fenfitive  motions,  which  are 
fometimes  mixed  with  the  vertiginous  ones,  and  fometimes  fep- 
arate  from  them. 


ORDO 


4 1 9  PISE ASES  CLASS  IV.  2. 3. 

ORDO  II. 

Decreafed  AJJbc'mte  Motions. 
GENUS  II. 

Catenated  with  Senjitive  Motions. 

IN  this  genus  the  fenforial  power  of  aflbciation  is  exerted  with 
Jefs  energy,  and  thence  the  actions  produced 'by  it  are  lefs  than 
natural ;  and  pain  is  produced  in  confequence,  according  to  the 
fifth  law  of  animal  caufation,  Sect.  IV.  This  pain  is  generally 
attended  with  coldnefs  of  the  affected  part,  and  is  feldom  fuc- 
ceeded  by  inflammation  of  it.  This  decreafed  action  of  the 
ifecondary  link  of  the  aflbciated  motions,  belonging  to  this  ge- 
nus, is  owing  to  the  previous  exhauftion  of  fenlbrial  power  either 
in  the  increafed  actions  of  the  primary  link  of  the  aflbciated  mo- 
tions, or  by  the  pain  which  attends  them  ;  both  which  are  fre- 
quently the  confequence  of  the  ftimulus  of  fomething  external 
to  the  affected  fibres. 

As  pain  is  produced  either  by  exrefs  or  defect  of  the  natural 
exertions  of  the  fibres,  it  is  not,  confidered  feparately,  a  criteri- 
on of  the  prefence  of  either.  In  the  aflbciations  belonging  to 
this  genus  the  fenfation  of  pain  or  pleafure  produces  or  attends 
the  primary  link  of  the  affociated  motions,  and  very  often  gives 
name  to  the  difeafe. 

When  great  pain  exifts  without  caufing  any  fibrous  motions, 
I  conjecture  that  it  contributes  to  exhauft  or  expend  the  gen- 
eral quantity  of  fenforial  power  ;  becaufe  people  are  fatigued 
by  enduring  pain,  till  at  length  they  fleep.  Which  is  contrary 
to  what  I  had  perhaps  erroneoufly  fuppofed  in  Sect.  XXXV. 
2.  3.  If  it  caufes  fibrous  motions,  it  then  takes  the  name  of 
fenfation,  according  to  the  definition  of  fenfation  in  Sect.  II.  2. 
9.  ;  and  increafed  fibrous  action  or  inflammation  is  the  confe- 
quence. This  circumftance  of  the  general  exhauftion  of  fenfo- 
rial power  by  the  exiftence  of  pain  will  afiift  in  explaining  ma- 
ny of  the  dileafes  of  this  genus. 

Many  of  the  canals  of  the  body,  as  the  urethra,  the  bile-duct, 
the  throat,  have  the  motions  of  their  two  extremities  affociated 
by  having  been  accuftomed  to  feel  pleafurable  or  painful  fenfa- 
tions  at  the  fame  time  or  in  fucceffion.  This  is  termed  fenfi- 
tive  aflbciation,  though  thofe  painful  or  pleafurable  fenfations 
do  not  caufe  the  motions,  but  only  attend  them ;  and  are  thus 
perhaps,  ftrictly  fpeaking,  only  catenated  with  them. 

SPECIES. 


CLASS IV.  2.  2.  i.        OF  ASSOCIATION.  413 

SPECIES. 

1.  Torpor  gerix  a  dolor e  dent'is.     In  tooth-ach  there  is  general- 
ly a  coldneis  of  the  cheek,  which  is  fenfible  to  the  hand,  and  is 
attended  in  fome  degree  with  the  pain  of  cold.     The  cheek  and 
tooth  have  frequently  been  engaged  in  pleafurable  action  at  the 
fame  time  during  the  mafticating  of  our  food ;  whence  they 
have  acquired  fenfitive  aflbciations.     The  torpor  of  the  cheek 
may  have  for  its  caufe  the  too  great  expenditure  of  fenforial 
power  by  the  painful  fenfation  of  the  membranes  of  the  difeaf- 
ed  tooth ;  whence  the  membranes  of  the  cheek  aiTociated  with 
thofe  of  the  alveolar  procefs  are  deprived  of  their  natural  (hare 
of  it,  and  become  torpid  ;  thus  they  produce  lefs  fecretions,  and 
lefs  heat,  and  the  pain  of  cold  is  the  confequeiice.     This  torpor 
of  the  veffels  of  the  cheek  cannot  be  produced  by  the  activity 
of  the  fenforial  power  of  fenfation  ;  for  then  they  would  act 
more  violently  than  natural,  or  become  inflamed.     And  though 
the  pain  by  exhauiting  fo  much  fenforial  power  may  be  a  re- 
mote  caufe,  it  is  the  defed;  of  the  power  of  affociation,  which 
is  the  immediate  caufe  of  the  torpor  of  the  cheek. 

After  fome  hours  this  pain  occafioncd  by  the  torpor  of  the 
vefiels  of  the  cheek  either  gradually  ceaies  along  with  the  pain 
of  the  difeafed  tooth  ;  or,  by  the  accumulation  of  fenforial  pow- 
er during  their  (late  of  torpor,  the  capillaries  of  the  cheek  act: 
with  greater  violence,  and  produce  more  fecretions,  and  heat, 
and  confequent  tumour,  and  inflammation.  In  this  ftate  the 
pain  of  the  difeafed  tooth  ceafes  •,  as  the  fenfovial  power  of  fen- 
fation is  now  expended  on  the  inflamed  veffels  of  the  cheek.  It 
is  probable  that  mod  other  internal  membranous  inflammations 
begin  in  a  fnnilar  manner ;  whence  there  may  feem  to  be  a  double 
kind  of  fenfitive  aiTociation ;  firft,  with  decreafed  action  of  the 
•  aflbciated  organ,  and  then  with  increafed  action  of  it  j  but  the 
latter  is  in  this  cafe  fimply  the  confequence  of  the  former  ;  that 
is,  the  tumour  or  inflammation  of  the  cheek  is  in  confequence 
of  its  previous  quiefcence  or  torpor. 

2.  Stranguria  a  dolore  vefica.     The  ftrangury,  which  has  its 
origin  from  pain  at  the  neck  of  the  bladder,  confifts  of  a  pain  in 
the  external  extremity  of  the  urethra  or  of  the  glands  penis  of 
men,  and  probably  in  the  external  termination  of  the  urethra  or 
of  the   clitoris  of  women  ;  and  is  owing  to  the  fympathy  of 
thefe  with  fome  diftant  parts,  generally  with  the  other  end  of 
the  urethra  ;  an  endeavour  and  difficulty  of  making  water  at- 
tends this  pain. 

Its  remote  caufe  is  from  the  internal  or  external  life  of  can- 
tharides,  which  ftimulate  the  neck  of  the  bladder ;  or  from  a 

ft  one. 


4 1 4  DISEASES  CLASS  IV.  2. 2. 3. 

ftone,  which  whenever  it  is  pulhed  into  the  neck  of  the  bladder, 
gives  this  pain  of  ftrangury,  but  not  at  other  times  -,  and  hence 
it  is  felt  moil  feverely  in  this  cafe  after  having  made  water. 

The  fenfations  or  fenfitive  motions  of  the  glands  penis,  and 
of  the  fphincler  of  the  bladder,  have  been  accuftomed  to  exift 
together  during  the  diicharge  of  the  urine •,  and  hence  the  two 
ends  of  the  urethra  fympathize  by  aflbciation.  When  there 
is  a  (lone  at  the  neck  of  the  bladder,  which  is  not  fo  large  or 
rough  as  to  inflame  the  part,  the  fphincler  of  the  bladder  be- 
comes Simulated  into  pain ;  but  as  the  glans  penis  is  for  the 
purpoies  of  copulation  more  fenfitive  than  the  fphincler  of  the 
bladder,  as  foon  as  it  becomes  affected  with  pain  by  the  aflbcia- 
tion above  mentioned,  the  fenfation  at  the  neck  of  the  bladder 
ceafes  ;  and  then  the  pain  of  the  glans  penis  would  feem  to  be 
aflbciated  with  the  irritative  motions  only  of  the  fphincler  of  the 
bladder,  and  not  with  the  fenfitive  ones  of  it.  But  a  circum- 
ftanre  fimilar  to  this  occurs  in  epileptic  fits,  which  at  firft  are 
induced  by  difagreeable  fenfation,  and  afterwards  feem  to  occur 
without  previous  pain,  from  the  fuddennefs  with  which  they 
follow  and  relieve  the  pain,  which  occafioned  them.  From  this 
analogy  I  imagine  the  pain  of  the  glans  penis  is  aflbciated  with 
the  pain  of  the  fphincler  of  the  bladder  ;  but  that  as  foon  as  the 
greater  pain  in  a  more  fenftble  part  is  produced  ;  the  lefs  paln^  'which 
occafioned  it,  ceafes ;  and  that  this  is  one  of  the  laws  of  fenfitive  af- 
fociation.  See  Sea.  XXXV.  2.  i. 

A  young  man  had  by  an  accident  fwallowed  a  large  fpoonful 
or  more  of  tinclure  of  cantharides  ;  as  foon  as  he  began  to  feel 
the  pain  of  ftrangury,  he  was  advifed  to  drink  large  quantities 
of  warmifh  water  :  to  which,  as  foon  as  it  could  be  gotten,  fome 
gum  arabic  was  added.  In  an  hour  or  two  he  drank  by  inter- 
vals of  a  few  minutes  about  two  gallons  of  water,  and  difcharg- 
ed  his  urine  every  four  or  five  minutes.  A  little  blood  was 
voided  towards  the  end,  but  he  fuffered  no  ill  confequence. 

M.  M.  Warm  water  internally.  Clyfters  of  warm  water. 
Fomentation.  Opium.  Solution  of  fixed  alkali  fuperfaturated 
with  carbonic  acid.  A  bougie  may  be  ufed  to  pufh  back  a  ftone 
into  the  bladder.  See  Clafs  I.  1.3.  10. 

3.  Stranguria  convulfiva.  The  convulfive  ftrangury,  like  that 
before  defcribed,  is  probably  occafioned  by  the  torpor  or  defec- 
tive aclion  of  the  painful  part  in  confequence  of  the  too  great 
expenditure  of  fenforial  power  on  the  primary  link  of  the  affbciat- 
ed  motions,  as  no  heat  or  inflammation  attends  this  violent  pain. 
This  kind  of  ftrangury  recurs  by  ftated  periods,  and  fometimes 
arifes  to  fo  great  a  degree,  that  convuliion  or  temporary  mad- 
nefs  terminates  each  period  of  it.  It  atFedts  women  oftener 

than 


CLASS  IV.  2.2.4.        OF  ASSOCIATION.  4 1 5 

than  men,  is  attended  with  cold  extremities  without  fever,  and 
is  diftinguifhed  from  the  ftone  of  the  bladder  by  the  regularity 
of  its  periods,  and  by  the  pain  being  not  increafed  after  making 
water. 

On  introducing  the  cathether  fometimes  part  of  the  urine  will 
come  away  and  not  the  whole,  which  is  difficult  to  explain  ; 
but  may  arife  from  the  weaknefs  of  the  mufcular  fibres  of  the 
bladder ;  which  are  not  liable  fuddenly  to  contract  themfelves 
fo  far  as  to  exclude  the  whole  of  the  urine.  In  fome  old  peo- 
ple, who  have  experienced  a  long  retention  of  urine,  the  blad- 
der never  regains  the  power  of  completely  emptying  itfelf ;  and 
many  who  are  beginning  to  be  weak  from  age  can  make  water 
a  fecond  time,  a  few  minutes  after  they  fuppofed  they  had  emp- 
tied the  bladder. 

I  have  believed  this  pain  to  originate  from  fympathy  with 
fome  diftant  part,  as  from  afcarides  in  the  rectum,  or  from  piles 
in  women  ;  or  from  caruncles  in  the  urethra  about  the  caput 
gallinaginis  in  men  ;  and  that  the  pain  has  been  in  the  glans  or 
clitoris  by  reverfe  fympathy  of  thefe  more  lenfible  parts  with 
thofe  above  mentioned. 

M.  M.  Venefedtion.  Opium  in  large  quantities.  Warm 
bath.  Balfams.  Bark.  Tincture  of  cantharides.  Bougie,  and 
the  treatment  for  hemorrhoids.  Leeches  applied  to  the  fphic- 
ter  ani.  Aerated  alkaline  water.  Soap  and  fal  foda.  Opium 
in  clyfters  given  an  hour  before  the  expected  return.  Smoke 
of  tobacco  in  clyfters.  Arfenic. 

4.  Dolor  termini  inteftinalis  duclus  choledochi.  Pain  at  the  in- 
teftinal  end  of  the  gall-duct.  When  a  gall-ftone  is  protruded 
from  the  gall-bladder  a  little  way  into  the  end  of  the  gall-duct, 
the  pain  is  felt  at  the  other  end  of  the  gall-duct,  which  termin- 
ates in  the  duodenum.  For  the  actions  of  the  two  terminations 
of  this  canal  are  affociated  together  from  the  fame  ftreams 
of  bile  patting  through  them  in  fucceflion,  exactly  as  the  two 
terminations  of  the  urethra  have  their  actions  aflbciated,  as 
defcribed  in  Species  2  and  3  "of  this  genus.  But  as  the  in- 
teftinal  termination  of  the  bile-duct  is  made  more  fenfible  for 
the  purpofe  of  bringing  down  more  bile,  when  it  is  ftimulated 
by  new  fupplies  of  food  from  the  ftomach,  it  falls  into  violent 
pain  from  afibciation  ;  and  then  the  pain  on  the  region  of  the 
gall-bladder  ceafes,  exactly  as  above  explained  in  the  account 
of  the  pain  of  the  glans  penis  from  a  ftone  in  the  fphinclcr  of 
the  bladder. 

The  common  bile-duct  opens  into  the  interline  exactly  at 
what  is  called  the  pit  of  the  ftomach ;  and  hence  it  has  fottle- 
fimes  happened,  that  this  p-iin  from  aflbciation  with  the  fcnfa- 

tion 


4i6  DISEASES  CLASS  IV.  2. 


tion  of  a  gall-done  at  the  other  end  of  the  bile-duct  has  been 
miftaken  for  a  pain  of  the  ftomach. 

For  the  method  of  cure  fee  Clafs  1.  1.3.  8.  to  which  mould 
be  added  the  uie  of  ftrong  electric  fhocks  pafled  through  the  bile- 
duct  from  the  pit  of  the  ftomach  to  the  back,  and  from  one  fide 
to  the  other.  A  cafe  of  the  good  effect  of  eledlricity  in  the 
jaundice  is  related  in  Sett.  XXX.  2.  And  another  cafe, 
where  it  promoted  the  paflage  of  a  painful  gall-ftone,  is  defcrib- 
ed  by  Dr.  Hall,  experienced  on  himfelf.  Tranf.  of  the  Col- 
lege at  Philadelphia,  Vol.  I  p.  192. 

Half  a  pint  of  warm  water  two  or  three  times  a  day  is  much 
recommended  to  dilute  the  infpiiikted  bile. 

5.  Dolor   plar  \ngls  nb  acids    gafinco.     The    two  ends  of  the 
throat    fympathize  by  fcniitive  aflbciation  in  the  fame  manner 
as  the  other  canals  above  mentioned,  namely,  the  urethra  and 
the  bile-duct  ;  hence  when  too    great  acidity  of  undigefted  ali- 
ment, or  the  carbonic  acid  air,  which  efcnpes  in  fermentation, 
ftimulates  the  cardia  ventriculi,  or  lower  end  of  the   gula,  into 
pain,  the  pharynx,  or  upper  end  of  it,   is  affected  with  greater 
pain,  or  a  difagreeablc  fenfation  of  heat. 

6.  Pruritus  narliim  a  vermibus.    The  itching  of  the  nofe  from 
worms  in  the  inteftines  is  another  curious  inftance  of  the   fen- 
fitive  afibciations  of  the  motions  of  membranes  ;  efpecially  of 
thofe  which  conftitute  the  canals  of  the  body.     Previous  to  the 
deglutition  of  agreeable  food,  as  milk  in  our  earlieft  infancy,  an 
agreeable  odour  affects  the  membrane,  which  lines  the  noftrils; 
and  hence  an  ailbciation  feems  to  take  place  between  the  agreea- 
ble fenfations  produced  by  food  in  the  ftomach  and  bowels,  arid 
the  agreeable  fenfations  of  the  noftrils.   •  The  exiftence  of  afcar- 
ides  in  the  rectum  I  believe  produces  this  itching  of  the  noftrils 
more  than  the  worms  in  other  parts  of  the  inteftines  j  as  we  have 
already  feen,  that  the  terminations  of  canals  fympathize  more 
than  their  other  parts,  as  in  the    urethra   and  gall-ducts.     See 
Clafs  I.    r.   5-   9.  IV.    i.   2.  9. 

7.  Cephalaa  fympathetica.   Sympathetic  head-ach.     In  cold  fits 
of  the  ague,  the  head-ach  arifes  from  confent  with  fome  torpid 
vifcns,  like  the  pain  of  the  loins.      After  drunkennefs  the  head- 

-  very  common,  owing  to  direct  fympathy  of  the  mem- 
branes of  with  thofe  of  the  ftomach  ;  which  is  become 
torpid  after  the  too  violent  ftimulus  of  the  preceding  intoxica- 
tion ;  and  is  hence  removable  by  fpirit  of  wine,  or  opium,  ex- 
hibited in  fmaller  quantities.  In  fome  conftitutions  thefe  head- 
achs  are  induced,  when  the  feet  are  expofed  to  much  external 
cold  ;  in  this  cafe  the  feet  fliouid  be  covered  with  oiled  (ilk, 

which 


CLASS  IV.  2.  2.  8.      OF  ASSOCIATION.  4 1 7 

which  prevents  the  evaporation  of  the  perfpirable  matter,  and 
thence  diminifhes  one  caufe  of  external  cold. 

M.  M.  Valerian  in  powder  two  drams  three  or  four  times 
a  day  is  recommended.  The  bark.  Chalybeates.  A  grain  of 
opium  twice  a  day  for  a  long  time.  From  five  to  ten  drops  of 
the  faturated  folution  of  arfenic  two  or  three  times  a  day.  See 
Clafs  I.  2.  4.  1 1.  A  lady  once  aflured  me,  that  when  her  head- 
ach  was  coming  on,  me  drank  three  pints  (pounds)  of  hot  water, 
as  hailily  as  me  could ;  which  prevented  the  progrefs  of  the  dif- 
eafe.  A  folution  of  arfenic  is  recomnaended  by  Dr.  Fowler  of 
York.  Very  ftrong  errhines  are  faid  fometimes  to  cure  head- 
achs  taken  at  the  times  ih~  pain  recurs,  till  a  few  drops  of  blood 
ifiue  from  the  noftrils.  As  one  grain  of  tupeth  mineral  (vitriol- 
ic calx  of  mercury)  mixed  with  ten  grains  of  fine  fugar,  Eu- 
phorbium  or  cayenne  pepper  mixed  with  fugar,  and  ufed  with 
caution  as  an  errhine.  See  the  M.  M.  of  the  next  Species. 

8.  Hemicraniafympathetica.  Sympathetic  pain  on  one  fide  of 
the  head.  This  difeafe  is  attended  with  cold  Ikin,  and  hence 
whatever  may  be  the  remote  caufe,  the  immediate  one  feems 
to  be  want  of  ftimulus,  either  of  heat  or  diftention,  or  of  fome 
other  unknown  ftimulus  in  the  painful  part  ;  or  in  thofe,  with 
which  it  is  ailbciated.  The  membranes  in  their  natural  (late 
are  only  irritable  by  diftention  ;  in  their  difeafed  ftate,  they  are 
fenfible  like  mufcular  fibres.  Hence  a  difeafed  tooth  may  ren* 
der  the  neighbouring  membranes  fenfible,  and  is  frequently  the 
caufe  of  this  difeafe. 

Sometimes  the  ftomach  is  torpid  along  with  the  pained  mem- 
brane of  the  head  j  and  then  ficknefs  and  inappetency  attend 
either  as  caufes  or  confequences.  The  natural  cure  of  hemi- 
crania  is  the  accumulation  of  fenforial  power  during  the  reft  or 

ficknefs  of  the  patient.     Mrs. is  frequently  liable  to  hem- 

icrania  with  ficknefs,  which  is  probably  owing  to  a  difeafed 
tooth ;  the  paroxyfm  occurs  irregularly,  but  always  after  fome 
previous  fatigue,  or  other  caufe  of  debility.  She  lies  in  bed, 
lick,  and  without  taking  any  folid  food,  and  very  little  of  fluids, 
and  thofe  of  the  aqueous  kind,  and,  after  about  48  or  50  hours, 
rifes  free  from  complaint.  Similar  to  this  is  the  recovery  from 
cold  paroxyfms  of  fever,  from  the  torpor  occafioried  by  fear, 
and  from  fyncope  ;  which  are  all  owing  to  the  accumulation  of 
fenforial  power  during  the  inactivity  of  the  fyftem.  Hence  it  ap- 
pears, that,  though  when  the  fenforial  power  of  volition  is  much 
cxhaufted  by  fatigue,  it  can  be  reftored  by  eight  or  ten  hours  of 
deep;  yet,  when  the  fenforial  power  of  irritation  is  exhaufted 
by  fatigue,  that  it  requires  two  whole  folar  or  lunar  days  of  refh, 
before  it  can  be  reftored. 

VOL.  IL  F  F  f  Th« 


4i8  DISEASES  CLASS  IV.  2. 2.  & 

The  late  Dr.  Monro  afferted  in  his  lectures,  that  he  cured  the 
hemicrania,  or  megrim,  by  a  ftrong  vomit,  and  a  brilk  purge 
immediately  after  it.  This  method  fucceeds  belt  if  opium  and 
the  bark  arc  given  in  due  quantity  after  the  operation  of  the 
cathartic ;  and  with  dill  more  certainty,  if  bleeding  in  final! 
quantity  is  premifed,  where  the  pulfe  will  admit  of  it.  Sec 
Sea.  XXXV.  2.  i. 

Mr.  Kellie  affcrts,  that  fome  kinds  of  head-achs,  efpecially 
thofe  which  arife  from  defect  of  ilimulation,  may  be  cured  by 
comprefhng  the  two  iubclavian  arteries,  as  they  pafs  over  the 
firft  rib  ;  which  he  thinks  would  produce  a  preflure  on  the  brain 
limilar  to  that,  which  rnay  be  produced  by  the  centrifugal  force, 
if  a  perfon  was  to  lie  acrofs  a  mill-done  as  it  revolves.  See 
Suppl.  I.  15'  7-  Would  fuch  a  circulating  bed  remove  any 
kind  of  head-ach  ? 

The  pain  generally  afreets  one  eye,  and  fpreads  a  Ititle  way 
on  that  ikie  of  the  nofe,  and  may  ibmetimes  be  relieved  by  preff- 
ing  or  cutting  the  nerve,  where  it  paffes  into  the  bone  of  the 
orbit  above  the  eye.  When  it  affects  a  fmall  defined  part  on 
the  parietal  bone  on  one  fide,  it  is  generally  termed  Clavus  hyf- 
tericus,  and  is  always  I  believe  owing  to  a  difeafed  dens  mola- 
ris.  The  tendons  of  the  mufcles,  which  ferve  the  office  of 
madication,  have  been  extended  into  pain  at  the  fame  time  that 
the  membranous  coverings  of  the  roots  of  the  teeth  have  been 
compreiTed  into  pain,  during  the  biting  or  maftication  of  hard 
:s.  Hence  when  the  membranes,  which  cover  the  roots  of 
;eth,  become  affected  with  pain  by  a  beginning  decay,  or 
perhaps  by  the  torpor  or  coldncfs  of  the  dying  part  of  the  tooth, 
the  tendons  and  membranous  fafcia  of  the  mufcles  about  the 
fame  fide  of  the  head  become  affected  with  violent  pain  by  their 
live  ailbciations  :•  and  as  ibon  as  this  aflbciated  pain  takes 
place,  the  pain  of  the  tooth  entirely  ceafes,  as  explained  in  the 
fecond  fpecies  of  this  genus. 

A  remarkable  circumdance  attends  this  kind  of  hemicrania, 
viz.  that  it  recurs  by  periods  like  thofe  of  intermittent  fevers,  as 
explained  in  the  Section  on  Catenation  of  Motions  ;  theie  peri- 
ods ibmetimes  correfpond  with  alternate  lunar  or  folar  days 
like  tertian  agues,  and  that  even  when  a  decaying  tooth  is  evi- 
dently the  caufe  ;  which  has  been  evinced  by  the  cure  of  the 
difeale  by  extracting  the  tooth.  At  other  times  they  obferve 
the  monthly  lunations,  and  feem  to  be  induced  by  the  debility, 
which  attends  menftruation. 

The  dens  fapientke,  or    lad  tooth   of  the   upper  jaw,  fre- 
quently decays  fird,  and  gives  hemicrania  over  the  eye  on  the 
fame  fide.     The  fird  or  fecond  grinder  in  the  under-jaw  is  lia- 
ble 


I 


CLASS  IV.  2.  2.  3.         OF  ASSOCIATION.  4 1 9 

ble  to  give  violent  pain  about  the  middle  of  the  parietal  bone,  or 
fide  of  the  head,  on  the  fame  fide,  which  is  generally  called  the 
Clavus  hyftericus,  of  which  an  inftructive  cafe  is  related  in 
Sea.  XXXV.  2.  i. 

Since  the  above  was  firft  publifhed  I  have  feen  two  cafes, 
which  were  very  fimilar,  and  fecm  much  to  confirm  the  above 
theory  of  fympathetie  hemicrania  being  perhaps  always  owing 
to  the  fympathy  of  the  membranes  about  the  cranium  with 
thofe  about  difeafed  teeth.  Lord  M.  and  Mr.  B.  of  Edinburgh, 
both  of  them  about  the  middle  of  life  were  afflicted  with  vio- 
lent hemicrania  for  about  two  years  ;  in  the  beginning  of  which 
time  they  both  affured  me,  that  their  teeth  were  perfectly  found, 
but  on  infpecting  their  mouths  I  found  all  the  molares  were 
now  fo  decayed  as  to  have  loft  their  crowns.  After  having  fuf- 
fered  pain  for  fixteen  or  eighteen  months  almoft  inceiYantly  in 
different  parts  of  their  heads,  they  had  each  of  them  a  hemiple- 
gia,  from  which  they  gradually  recovered,  as  much  as  paralytic 
affections  generally  do  recover.  All  the  {lumps  of  their  teeth, 
which  were  ufelefs,  were  directed  to  be  extracted  ;  as  the  fwal- 
lowing  fo  much  putrid  matter  from  decaying  bones  feemed  to 
injure  their  digeftion.  They  were  defired  not  to  drink  wine  or 
ale  without  its  being  diluted  with  twice  or  thrice  its  quantity  of 
water,  to  prevent  any  accefs  of  torpor  from  too  great  previous 
flimulus,  and  to  take  fix  grains  of  rhubarb  with  three  of  fonp 
made  into  pills,  every  night,  with  fome  bitter  and  very  flight 
chalybeate  medicines.  If  the  teeth  which  became  torpid  in  fuc- 
ceffion,  could  have  been  difcovered,  and  extracted,  before  they 
decayed,  and  could  have  been  replaced,  might  not  this  continu- 
ance of  pain,  and  confequent  paralyfis,  have  been  prevented  ?  or 
might  not  a  moderate  faiivation  have  effected  this  purpofe  ? 

M.  M.  Detect  and  extract  the  difeafed  tooth.  Cut  the  af- 
fected nerve,  or  ftimulate  the  difeafed  membrane  by  acupunc- 
ture. Venefection  to  fix  ounces  by  the  lancet  or  by  leeches. 
A  flrong  emetic  and  a  fubfequent  cathartic  ;  and  then  an  opiate 
and  the  bark.  Pafs  fmall  electric  (hocks  through  the  pained 
membrane,  and  through  the  teeth  on  the  fame  fide.  Apply  vit- 
riolic ether  externally,  and  a  grain  of  opium  with  camphor  in- 
ternally, to  the  cheek  on  the  affected  fide,  where  a  difeafed  tooth 
may  be  fufpected.  Foment  the  head  with  warm  vinegar. 
Drink  two  large  fpoonfuls  of  vinegar.  Stimulate  the  gums  of 
the  futpected  teeth  by  oil  of  cloves,  by  opium.  See  Clafs  I.  i. 
4.  4.  Snuff  volatile  fpirit  of  vinegar  up  the  noftrils.  Laflly, 
in  permanent  head-achs,  as  in  permanent  vertigo,  I  have  feen 
good  effect  in  two  cafes  by  the  ufc  of  mercurial  ointment  rubbed 
on  the  fhaved  head  or  about  the  throat,  till  a  mild  faiivation  com- 
mences, 


DISEASES  CLASS  IV.  2. 2. 9. 

mences,  which  by  inflaming  the  membranes  of  the  teeth  may 
prevent  their  irritative  fympathy  with  thpfe  of  the  cranium. 
Thus  by  inflaming  the  tendon,  which  is  the  caufe  of  locked  jaw, 
and  probably  by  inflaming  the  wound,  which  is  the  caufe  of  hy- 
drophobia, thofe  difeafes  may  be  cured,  by  difuniting  the  irrita- 
tive fympathy  between  thofe  parts,  which  may  not  poflefs  any 
fenfitive  fympathy.  This  idea  is  well  worth  our  attention. 

Otalgia.  Ear-ach  is  another  difeafe  occasioned  by  the  fympa- 
thy of  the  membranes  of  the  ear  with  thofe  which  inveft  or  fur- 
round  a  decaying  tooth,  as  I  have  had  frequent  reafon  to  be- 
lieve j  and  is  frequently  relieved  by  filling  the  ear  with  tincture 
of  opium.  See  Clafs  I.  2.  4. 

9.  Dolor  humeri  in  hepatidide.     In  the  efforts  of  excluding  the 
faeces  and  urine  the  mufcles  of  the  moulders  are  exerted  to  com- 
prefs  the  air  in  the  lungs,   that  the  diaphragm  may  be  prefTed 
down.     Hence  the  diftention  of  the  tendons  or  fibres  of  thefe 
mufcles  is  aflbciated  with  the  diftention  of  the  tendons  or  fibres 
of  the  diaphragm ;  and  when  the  latter  are  pained  by  the  en- 
largement or  heat  of  the  inflamed  liver,  the  former  fympathize 
with  them.     Sometimes  but  one  fhoulder  is  affected,  fometimes 
both ;  it  is  probable  that  many  other  pains,  which  are  termed 
rheumatic,  have  a  fimilar  origin,  viz.   from   fenfitive  aflbciar 
tions. 

As  no  inflammation  is  produced  in  confequence  of  this  pain 
of  the  fhoulder,  it  feems  to  be  owing  to  inaction  of  the  mem- 
branous part  from  defect  of  the  fenforial  power  of  aflbciation, 
of  which  the  primary  link  is  the  inflamed  membrane  of  the  liv- 
er ;  which  now  expends  fo  much  of  the  fenforial  power  in  gen- 
eral by  its  increafed  action,  that  the  membranes  about  the  (houl- 
der,  which  are  links  of  aflbciation  with  it,  become  deprived  of 
their  ufual  fhare,  and  confequently  fall  into  torpor. 

10.  Torpor  pedurn  in  eruptione  variolarum.     At  the  commence- 
ment of  the  eruption  of  the  fmall-pox,  when  the  face  and  breaft 
of  children  are  very  hot,  their  extremities  are  frequently  cold. 
This  I  afcribe  to  fenfitive  afTociation  between  the  different  parts 
of  the  fkin  ;  whence  when  a  part  acts  too  violently,  the  other 
part  is  liable  to  act  too  weakly  ;  and  the  fkin  of  the  face  being 
affected  firft  in  the   eruption  of  the  fmall-pox,  the  fkin  of  the 
feet  becomes  cold  in  confequence  by  reverfe  fympathy. 

M.  M.  Cover  the  feet  with  flannel,  and  expofe  the  face  and 
bofom  to  cool  air,  which  in  a  very  fhort  time  both  warms  the 
feet  and  cools  the  face  ;  and  hence  what  is  erroneoufly  called  a 
rafh,  but  which  is  probably  a  too  hafly  eruption  of  the  fmall-pox, 
difappears ;  and  afterwards  fewer  and  more  diftinct  eruptions 
of  the  fmall-pox  fupervene. 

1 1.  Tejlium 


CLASS  IV.  2.2.11.       OF  ASSOCIATION.  421 

i  i.  Teftittm  dolor  nephriticus.  The  pain  and  retracYion  of  the 
tefticle  on  the  fame  fide,  when  there  is  a  ftone  in  the  ureter,  is 
to  be  afcribed  to  fenfitive  aifociation  ;  whether  the  connecting 
caufe  be  a  branch  of  the  fame  nerve,  or  from  membranes,  which 
have  been  frequently  affected  at  the  lame  time. 

12.  Dolor  digiti  minimi  fympatheticus.     When  any  one   acci- 
dentally ftrikes  his  elbow  againft  any  hard  body,  a  tingling  pain 
runs  down  to  the  little  finger  end.     This  is  owing  to  fenfitive 
affbciation  of  motions  by  means  of  the  fame  branch  of  a  nerve, 
as  in  hemicrania  from  a  decaying  tooth  the  pain  is  owing  to  the 
fenfitive  affociation  of  tendons  or  membranes. 

13.  Dolor  brachiiin  hydrope  peftoris.    The  pain  in  the  left  arm 
which  attends  fome  dropfies  of  the  cheft,  is  explained  in  Seel:. 
XXIX.  5.   2.    10.  which  refembles  the  pain  of  the  little  ringer 
from  a  percuflion  of  the  nerve  at  the  elbow  in  the  preceding  ar- 
ticle.    A  numbnefs  of  this  kind  is  produced  over  the  whole  leg, 
when  the  crural  nerve  is  much  comprefled  by  fitting  for  a  time 
with  one  leg  crofled  over  the  other. 

Mr.  ,  about  fixty,  had  for  two  years  been  affected  with 

difficulty  of  refpiration  on  any  exertion,  with  pain  about  the  fter- 
num,  and  of  his  left  arm  ;  which  lad  was  more  confiderable 
than  is  ufual  in  dropfy  of  the  cheft  ;  fome  months  ago  the  pain 
of  his  arm,  after  walking  a  mile  or  two,  became  exceffive,  with 
coldnefs  and  numbnefs  ;  and  on  the  next  day  the  back  of  the 
hand,  and  a  part  of  the  arm  fwelled  and  became  inflamed,  which 
relieved  the  pain ;  and  was  taken  for  the  gout,  and  continued 
feveral  days.  He  after  fome  months  became  dropfical  both  in 
refpect  to  his  cheft  and  limbs,  and  was  fix  or  feveri  times  per- 
fectly relieved  by  one  dram  of  faturated  tincture  of  digitalis, 
taken  two  or  three  times  a  day  for  a  few  days  in  a  glafs  of  pep- 
permint water.  He  afterwards  breathed  oxygen  gas  undiluted, 
in  the  quantity  of  fix  or  eight  gallons  a  day  for  three  or  four 
weeks  without  any  effect,  and  funk  at  length  from  general  de- 
bility. 

In  this  inftructive  cafe  I  imagine  the  prefiure  or  ftimulus  of 
one  part  of  the  nerve  within  the  cheft  caufecl  the  other  part, 
which  ferves  the  arm,  to  become  torpid,  and  contequenily  cold 
by  fympathy ;  and  that  the  inflammation  was  the  confequence 
of  the  previous  torpor  and  coldnefs  of  the  arm,  in  the  fame 
manner  as  the  fvvelling  and  inflammation  of  the  cheek  in  tooth- 
ach,  in  the  firft  fpecies  of  this  genus  •,  and  that  many  rheumatic 
inflammations  are  thus  produced  by  fympathy  with  fome  dif- 
tant  part. 

14.  Diarrhoea  a  dentitione.     The  diarrhoea,  which  frequently 
attends  dentition,  is  the  confequence  of  indigeftion  ;  the  aliment 

acquires 


422  DISEASES          CLASS  IV.  2.  2.  14. 

acquires  chemical  changes,  and  by  its  acidity  acts  as  a  cathar- 
tic ;  and  changes  the  yellow  bile  into  green,  which  is  evac- 
uated along  with  indigefted  parts  of  the  coagulum  of  milk. 
The  indigeftion  is  owing  to  the  torpor  of  the  ftomach  and  intef- 
tines  caufed  by  their  aflbciation  with  the  membranes  of  the 
gums,  which  are  now  ftimulated  into  great  exertion  with  pain  ; 
both  which  contribute  to  expend  the  general  quantity  of  fen- 
forial  power,  which  belongs  to  this  membranous  aflbciation ; 
and  thus  the  ftomach  and  inteftines  aft  with  lefs  than  their 
natural  energy.  This  is  generally  efteemed  a  favourable  fymp- 
tom  in  difficult  dentition,  as  the  pain  of  the  alveolar  membranes 
cxhaufts  the  fenforial  power  without  producing  convulfions  for 
its  relief.  See  Clafs  I.  i.  4.  5.  And  the  diarrhoea  ceafes,  as 
the  tooth  advances. 


ORDO 


CLASS  IV.  2.  3.  i.        OF  ASSOCIATION.  4*3 

ORDO   II. 

Decreafed  AJficiate  Motions* 

GENUS  III. 

Catenated  •with  Voluntary  Motions. 
SPECIES. 

1.  Titubatio  lingua.     Impediment  of  fpeech  is  owing  to  the 
atTociations  of  the  motions  of  the  organs  of  fpeech  being  inter- 
rupted or  diflevered  by  ill-employed  fenfation  or  fenfitive   mo- 
tions, as  by  awe,  baiM ulnefs,  ambition  of  mining,  or  fear  of  not 
fucceeding,  and  the  perfon  ufes  voluntary  efforts  in  vain  to  re- 
gain the  broken  aflbciations,  as  explained  in  Seel.  XVII.   i.   10. 
and  XVII.  2.   10. 

The  broken  afibciation  is  generally  between  the  firft  confo- 
nant  and  the  fucceeding  vowel ;  as  in  endeavouring  to  pronounce 
the  word  parable,  the  p  is  voluntarily  repeated  again  and  again, 
but  the  remainder  of  the  word  does  not  follow,  becaufe  the  af- 
fociation  between  it  and  the  next  vowel  is  diflevered. 

M.  M.  The  art  of  curing  this  defe£l  is  to  caufe  the  flam- 
merer  to  repeat  the  word,  which  he  finds  difficult  to  fpeak, 
eight  or  ten  times  without  the  initial  letter,  in  a  ftrong  voice,  or 
with  an  afpirate  before  it,  as  arable,  or  harable  ;  and  at  length 
to  fpeak  it  very  foftly  with  the  initial  letter  p,  parable.  This 
(hould  be  praclifed  for  weeks  or  months  upon  every  word, 
which  the  Hammerer  hefitates  in  pronouncing.  To  this  mould 
be  added  much  commerce  with  mankind,  in  order  to  acquire 
a  careleflhefs  about  the  opinions  of  others. 

2.  Chorea  Sti  Viti.     In  the  St.  Vitus's  dance  the  patient  can 
at  any  time  lie  ftill  in  bed,  which  (hews  the  motions  not  to  be 
convulfive  ;  and  he  can  at  different  times  voluntarily  exert  every 
mufcle  of  his  body  -,  which  evinces,  that  they  are  not  paralytic. 
In  this  difeafe  the  principal  mufcle  in  any  defigned  motion  obeys 
the  will  $  but  thofe  mulcles,  whofe  motions  were  aflbciated  with 
the  principal  one,  do  not  a£l ;  as  their  aflbciation    is  diflevered, 
and  thus  the  arm  or  leg  is  drawn  outward,  or  inward,  or  back- 
ward, inilead  of  upward  or  forward,  with  various  geiliculations 
exactly  refembling  the  impediment  of  fpeech. 

This  difeafe  is  frequently  left  after  the  itch  has  been  too  haftily 
cured.  See  ctfnvulfio  dolorifica,  Clafs  III.  i.  i.  6.  A  girl 
about  eighteen,  after  wearing  a  mercurial  girdle  to  cure  the  itch, 

acquired 


424  DISEASES  CLASS  IV.  2. 3. 3, 

acquired  the  Chorea  St.  Viti  in  fo  univerfal  a  manner,  that  her 
fpeech  became  affecled  as  well  as  her  hmbs  ;  and  there  was  evi- 
dently a  difunion  of  the  common  trains  of  ideas  ;  as  the  itch 
was  ftiil  among  the  younger  children  of  the  family,  fhe  was  ad- 
vifed  to  take  her  fitter  as  a  bedfellow,  and  thus  received  the  itch 
again  ;  and  the  dance  of  St.  Vitus  gradually  ceafed.  See  Clafs 
II.  i.  5.  6. 

M.  M.  Give  the  patient  the  itch  again.  Calomel  a  grain 
every  night,  or  fublimate  a  quarter  of  a  grain  twice  a  day  for  a 
fortnight.  Steel.  Bark.  Warm  bath.  Cold  bath.  Opium. 
Venefection  once  at  the  beginning  of  the  difeafe.  Electricity. 
Perpetual  How  and  repeated  efforts  to  move  each  limb  in  the 
defigned  direction,  as  in  the  titubatio  linguae  above  defcribed. 

3.  Rifus.     Laughter  is  a  perpetual  interruption  of  voluntary 
exertion  by  the  interpofition  of  pleafurable  fenfation  ;  which  not 
being  checked  by  any  important  confequences  rifes  into   pain, 
and  requires  to  be  relieved  or  moderated  by  the  frequent  repe- 
tition of  voluntary    exertion.     See  Sect.  XXXIV.     I   4.  and 
Clafs  III.   i.   i.   4.  and  IV.   i.  3.  3. 

4.  Tremor  ex  ira.     The  trembling  of  the  limbs  from  anger. 
The  interruption  of  the  voluntary  aflbeiations  of  motions  by  an- 
ger, originates  from  too  great  a  part  of  the  fenforial  power  being 
exerted  on  the  organs  of  fenfe  ;  whence  the  mufcles,  which  ought 
to  fupport  the  body  upright,  are  deprived  of  their  due  quantity, 
and  tremble  from  debility.     See  Clafs  III.  2.   i.   I. 

5.  Rubor  extra.     Rednefs  from  anger.     Anger  is  an  excefs 
of  aver(ion,sthat  is  of  voluntarily  not  yet  employed.     It  is  excit- 
ed by  the  pain  of   offended  pride ;   when   it  is  employed  it  be- 
comes outrage,   cruelty,  infanity.     The  cutaneous   capillaries, 
efpecially  thofe  of  the  face,  are  more  mobile,  that  is,  more  eafi- 
ly  excited  into  increafed  action,  or  more  eafily  become  torpid, 
from  lefs  variation  of  fenforial  power,  than    any  other  parts  of 
the  fyftem,  which  is  owing  to  their  being  perpetually  fubject  to 
the  vicifTitudes  of  heat  and  cold,  and  of  extenfion   and  corruga- 
tion.    Hence,  when  an  excefs.  of  voluntarity  exifts  without  be- 
ing immediately  expended  in    the  actions  of  the  large  mufcles, 
the  capillary  arteries  and  glands  acquire  more  energetic  action, 
and  a  flufhed  fkin  is  produced,  with  increafed  fecretion  of  per- 
fpirable  matter,  and  confequent  heat,  owing  to  the  paufe  or  in- 
terruption of  voluntary  action  ;  -and  thus  the  actions  of   thefe 
cutaneous  veflels  become  ailbciated  between  the  irafcent  ideas 
and  irafcent  mufcular  actions,  which  are  thus  for  a  time  inter- 
rupted. 

6.  Rubor  criminati.     The  blufhing  of  accufed  people,  wheth- 
er guilty  or  not,  appears  to  be  owing  to  circumiiances  fimilar  to 

that 


CLASS  IV.  2.3.7.       OF  ASSOCIATION.  425 

that  of  anger ;  for  in  thefe  fituations  there  is  always  a  fudden 
voluntarily,  or  wi(h,  of  clearing  their  characters  arifes  in  the 
mind  of  the  accufed  perfon ;  which,  before  an  opportunity  is 
given  for  it  to  be  expended  on  the  large  mufcles,  influences  the 
capillary  arteries  and  glands,  as  in  the  preceding  article.  Whence 
the  increafed  actions  of  the  capillaries,  and  the  confequent  red- 
nefs  and  heat,  become  exerted  between  the  voluntary  ideas  of 
felf-defence,  and  the  mufcular  actions  neceflary  for  that  purpofe; 
which  laft  are  thus  for  a  time  interrupted  or  delayed.  ^ 

Even  in  the  blufh  of  modefty  or  bafhfulnefs  there  is  a  felf- 
condemnation  for  fome  fuppofed  defect  or  indecorum,  and  a 
fudden  voluntarity,  or  wifli,  of  felf-defence  ;  which  not  being 
expended  in  actions  of  the  larger  mufcles  excites  the  capillaries 
into  action ;  which  in  thefe  fubjects  are  more  mobile  than  in 
others. 

The  blufti  of  young  girls  on  coming  into  an  afTembly  room$ 
where  they  expect  their  drefs,  and  Heps,  and  manner,  to  be  ex- 
amined, as  in  dancing  a  minuet,  may  have  another  origin  ;  and 
may  be  confidered  as  a  hot  fit  of  returning  confidence,  after  a 
previous  cold  fit  of  fear. 

7.  Tarditas  par alytica.  By  a  ftroke  of  the  palfy  or  apoplexy- 
it  frequently  happens,  that  thofe  ideas  which  were  aflbciated  in 
trains,  whofe  firft  link  was  a  voluntary  idea,have  their  connection 
diflevered  ;  and  the  patient  is  under  the  neceflity,  by  repeated 
efforts,  flowly  to  renew  their  aflbciations.  In  this  fituation  thofe 
words,  which  have  the  feweft  other  words  aflbciated  with  them, 
as  the  proper  names  of  perfons  or  places,  are  the  moft  difficult 
to  recollect.  And  in  thofe  efforts  of  recollection  the  word  op- 
pofite  to  the  word  required  is  often  produced,  as  hot  for  cold, 
v/inter  for  fummer,  which  is  owing  to  our  aflbciating  our  ideas 
of  things  by  their  oppofites  as  well  as  by  their  fimilitudes,  and 
in  fome  inftances  perhaps  more  frequently,  or  more  forcibly. 
Other  paralytic  patients  are  liable  to  give  wrong  names  to  exter- 
nal objects,  as  ufing  the  word  pigs  for  fheep,  or  cows  for  horfes  ; 
in  this  cafe  the  aflbciation  between  the  idea  of  the  animal  and. 
the  name  of  it  is  diflevered  ;  but  the  idea  of  the  clafs  or  genus  of 
the  thing  remains  ;  and  he  takes  a  name  from  the  firft  fpecies 
which  prefents  itfelf,  and  fometimes  can  correct  himfelf,  till  he 
finds  the  true  one. 

8.  Tarditas  fem/is.  Slownefs  of  age.  The  difficulty  of  aflb- 
ciating ideas  increafes  with  our  age  ;  as  may  be  obferved  from 
old  people  forgetting  the  bufinefs  of  the  laft  hour,  unlefs  they 
imprefs  it  ftrongly,  o*by  frequent  repetition,  though  they  can 
well  recollect  the  tranfactions  of  their  youth.  I  faw  an  elderly 
man,  who  could  reafon  with  great  clearness  and  precision,  and 

VOL.  II.  G  Q  g  in 


426  DISEASES  CLASS  IV*  2. 3. 8. 

in  accurate  language  on  fubjects,  which  he  had  been  accuftomed 
to  think  upon  ;  and  yet  did  not  know  that  he  had  rung  the  bell 
by  his  fire-fide  in  one  minute  afterwards ;  nor  could  then  recol- 
lect the  object  he  had  wanted,  when  his  fervant  came. 

Similar  to  this  is  the  difficulty  which  old  people  experience  in 
learning  new  bodily  movements,  that  is,  in  aflbciating  new  muf- ' 
cular  actions,  as  in  learning  a  new  trade  or  manufacture.     The 
trains  of  movements,  which  obey  volition,  are  the  laft  which  we 
acquire  ;  and  the  firft,  which  are  difibciated. 

The  fymbols  moft  in  ufe,  with  which  we  have  aflbciated  ideas, 
are  thofe  of  vifible  and  of  audible  language.  It  is  curious  to  ob- 
(erve  in  the  inftruction  of  young  people,  that  fome  remember 
written  language  the  beft,  and  others  vocal  language.  The  fame 
thing  fometimes  occurs  in  aged  people,  that  is,  that  fome  lofe 
the  ideas  aflbciated  with  founds  fooneft,  and  others  thofe  aflb- 
ciated with  letters.  See  recollectionis  jactura,  Clafs  III.  2.  2.  I. 
and  Tarditas  paralytica  above. 

The  following  curious  account  of  this  defect  of  aflbciation  of 
ideas  with  audible  but  not  with  vifible  fymbols  was  fent  me  by 
Dr.  Darwin  of  Shrewfbury. 

«  The  cafe  of  an  old  man  lately  occurred  to  me,  who  was  fu* 
peranuated ;  his  hearing  and  vifion  were  perfect,  but  he  could 
only  call  up  a  train  of  ideas  from  the  latter.  When  he  was  told 
it  was  nine  o'clock,  and  time  for  him  to  eat  his  breakfaft,  he  re- 
peated the  words  distinctly  but  without  underftanding  them. 
His  fervant  put  a  watch  into  his  hand.  "  Why,  William,  have 
not  I  my  breakfaft,  for  it  is  juft  nine  o'clock  r*  he  would  fay 
with  expreflion,  that  mewed  he  felt  what  he  faid. 

«  On  almoft  every  occafion  his  fervants  converfed  with  him 
by  vifible  objects,  although  his  hearing  was  perfect ;  and  when 
this  kind  of  communication  was  ufed,  he  did  not  appear  impair- 
ed in  his  intellects.  This  ftate  came  on  from  a  ftroke  of  the 
palfy  5  and  till  he  and  his  attendants  ufed  this  kind  of  language 
he  was  quite  childifti." 


ORDO 


CLASS  IV.  2. 4.         OF  ASSOCIATION. 

ORDO  II. 

Decrtafed  Affbciate  Motions, 

GENUS  IV. 
Catenated  with  External  Influences* 

As  the  difeafes,  which  obey  fol  r  or  lunar  periods,  commence 
with  torpor  or  inactivity,  fuch  as  the  cold  paroxyfms  of  fevers, 
the  torpor  and  confequent  pain  of  hemicrania,  and  the  pains 
which  precede  the  fits  of  epilepfy  and  convulfion,  it  would  feem, 
that  thefe  difeafes  are  more  generally  owing  to  the  diminution 
than  to  the  excefs  of  folar  or  lunar  gravitation ;  as  the  difeafes 
which  originate  from  the  influence  of  the  matter  of  heat,  are 
much  more  generally  in  this  country  produced  by  the  defect 
than  by  the  excefs  of  that  fluid. 

The  periodic  returns  of  fo  many  difeafes  coincide  with  the 
diurnal,  monthly,  and  annual  rounds  of  time  5  that  any  one,  who 
would  deny  the  influence  of  the  fun  and  moon  on  the  periods 
of  quotidian,  tertian,  and  quartan  fevers,  muft  deny  their  effect 
on  the  tides,  and  on  the  feafons.  It  has  generally  been  believed, 
that  folar  and  lunar  effect  was  exerted  on  the  blood ;  which 
was  thus  rendered  more  or  lefs  (limulant  to  the  fyftem,  as  de- 
fcribed  in  Seel.  XXXII.  6.  But  as  the  fluid  matter  of  gravita- 
tion permeates  and  covers  all  things,  like  the  fluid  matter  of 
heat  5  I  am  induced  to  believe,  that  gravitation  afts  in  its  medi- 
um ftate  rather  as  a  caufa  fine  qua  non  of  animal  motion  like 
heat  5  which  may  diforder  the  fyftem  chemically  or  mechanical- 
ly, when  it  is  dimini(hed ;  but  may  neverthelefs  ftimulate  it, 
when  increafed,  into  animal  exertion. 

Without  heat  and  motion, which  fome  philofophers  ftill  believe 
to  be  the  fame  thing,  as  they  fo  perpetually  appear  together,  the 
particles  of  matter  would  attract  and  move  towards  each  other, 
and  the  whole  univerfe  freeze  or  coalefce  into  one  folid  mafs. 
Thefe  therefore  counteract  the  gravitation  of  bodies  to  one  cen- 
tre ;  and  not  only  prevent  the  planets  from  falling  into  the  fun, 
but  become  either  the  efficient  caufes  of  vegetable  and  animal 
life,  or  the  caufes  without  which  life  cannot  exift  ;  as  by  their 
means  the  component  particles  of  matter  are  enabled  to  flide  over 
each  other  with  all  the  various  degrees  of  fluidity  and  repul- 
fion. 

As  the  attra&ion  of  the  moon  countervails  or  diminifhes  the 
terrene  gravitation  of  bodies  on  the  furface  of  the  earth  ;  a  tide 

rifes 


DISEASES  CLASS  IV.  2. 4. 

rifes  on  that  fide  of  the  earth,  which  is  turned  towards  the 
moon ;  and  follows  it,  as  the  earth  revolves.  Another  tide  is 
raifed  at  the  fame  time  on  the  oppofite  fide  of  the  revolving 
earth,  which  is  owing  to  the  greater  centrifugal  motion  of  that  fide 
of  the  earth,  which  counteracts  the  gravitation  of  bodies  near  its 
furface.  For  the  earth  and  moon  may  be  considered  as  two  can- 
non balls  of  different  iizes  held  together  by  a  chain,  and  revolv- 
ing once  a  month  round  a  common  centre  of  gravity  between 
them,  near  the  earth's  furface  ;  at  the  fame  time  that  they  per- 
form their  annual  orbits  routed  the  fun.  Whence  the  centrifu- 
gal force  of  that  fide  of  the  earth,  which  is  fartheft  from  this  cen- 
tre of  motion,  round  which  the  earth  and  moon  monthly  re- 
volve, is  confiderably  greater,  than  the  centrifugal  force  of  that 
fide  of  the  earth  which  is  neareft  it ;  to  which  Should  be  added, 
that  this  centrifugal  force  not  only  contributes  to  diminim  the 
terrene  gravitation  of  bodies  on  the  earth's  furface  on  that  fide 
furtheft  from  the  centre  of  motion,  but  alfo  to  increafe  it  on  that 
fide,  which  is  neareft  it. 

Another  circumftance,  which  tends  to  raife  the  tide  on  the  part 
of  the  earth's  furface,  which  is  moft  diftant  from  the  moon,  is, 
that  the  attraction  of  the  moon  is  lefs  on  that  part  of  the  ocean, 
than  it  is  on  the  other  parts  of  the  earth.  Thus  the  moon  may 
be  fuppofed  to  attract  the  water  on  the  fide  of  the  earth  neareft 
it  With  a  power  equal  to  three ;  and  to  attract:  the  central  parts 
of  the  earth  with  a  power  equal  to  two  ^  and  the  water  on  the 
part  of  the  earth  moft  diftant  from  the  moon  with  a  power  only 
equal  to  one.  Hence  on  the  fide  of  the  earth  moft  diftant  from 
the  moon,  the  moon's  attraction  is  lefs,  and  the  centrifugal  force 
round  their  common  centre  of  motion  is  greater  ;  both  which 
contribute  to  raife  the  tides  on  that  fide  of  the  earth.  On  the 
fide  of  the  earth  neareft  the  moon,  the  moon's  attraction  is  fo 
much  greater  as  to  raiie  the  tides  ;  though  the  centrifugal  force 
pf  the  furface  of  the  earth  round  their  common  centre  of  mo- 
tion in  fome  degree  oppofes  this  effect. 

On  thefe  accounts,  when  the  moon  is  in  the  zenith  or  nadir, 
the  gravitation  of  bodies  on  the  earth's  furface  will  be  greateft 
at  the  two  oppofite  quadratures  ;  that  is,  the  greateft  gravitation 
of  bodies  on  the  earth's  furface  towards  her  centre  during  the 
lunar  day  is  about  fix  hours  and  a  half  after  the  fouthing,  or  af- 
ter the  northing  of  the  moon. 

Circumftances  fimilar  to  thefe,  but  in  a  lefs  degree,  muft  oc- 
cur in  reipeti:  to  the  folar  influence  on  terreftrial  bodies  ;  that 
is,  there  muft  be  a  diminution  of  the  gravity  of  bodies  near 
the  earth's  furface  at  noon,  when  the  fun  is  over  them  ;  and  al- 
fo at  midnight  from  the  greater  centrifugal  force  of  that  fide  of 

the 


CLASS  IV.  2. 4.  i .       OF  ASSOCIATION.  429 

the  earth,  which  is  mod  diftant  from  the  centre,  round  which 
the  earth  moves  in  her  annual  orbit,  than  on  the  fide  neareft 
that  centre.  Whence  it  likewife  follows,  that  the  gravitation  of 
bodies  towards  the  earth  is  greateft  about  fix  hours  after  noon, 
and  after  midnight. 

Now  when  the  fun  and  moon  have  their  united  gravitation  on 
the  fame  fide  of  the  earth,  as  at  the  new  moon  ;  or  when  the 
folar  attraction  coincides  with  the  greater  centrifugal  motion  of 
that  fide  of  the  earth,  which  is  furtheft  diftant  from  the  moon, 
as  at  the  full  moon  ;  and  when  this  happens  about  noon  or  mid- 
night, the  gravitation  of  terrene  bodies  towards  the  earth  will  be 
greater  about  fix  hours  after  noon,  and  after  midnight,  than  at 
any  other  part  of  the  lunar  period ;  becaufe  the  attradlion  of 
both  thefe  luminaries  is  then  exerted  on  thofe  fides  of  the  earth 
over  which  they  hang,  which  at  other  times  of  the  month  are 
more  or  lefs  exerted  on  other  parts  of  it. 

Laftly,  as  heat  and  motion  counteract  the  gravitation  of  the 
particles  of  bodies  to  each  other,  and  hence  become  either  the 
efficient  caufes  of  vegetable  and  animal  life,  or  the  caufes  with- 
out which  life  cannot  exift,  it  feems  to  follow,  that  when  our 
gravitation  towards  the  earth's  centre  is  greateft,  the  powers  of 
life  fhould  be  the  leaft  ;  and  hence  that  thofe  difeafes,  which 
begin  with  torpor,  mould  occur  about  fix  hours  <..fter  the  folar  or 
lunar  noon,  or  about  fix  hours  after  the  folar  or  lunar  midnight ; 
and  this  moft  frequently  about  fix  hours  after  or  before  the  new  or 
full  moon  ;  and  efpecially  when  thefe  happen  at  noon  or  at  mid- 
night ;  or  laftly,  according  to  the  combination  of  thefe  powers  in 
diminiming  or  increafing  the  earth's  attraction  to  bodies  on  its 
furface. 

The  returns  or  exacerbations  of  many  fevers,  both  irritative 
and  inflammatory,  about  fix  in  the  evening,  and  of  the  periodic 
cough  defcribed  in  Sect.  XXXVI.  3.  9.  countenance  this  theo- 
ry. Tables  might  be  made  out  to  mew  the  combined  powers 
of  the  fun  and  moon  in  diminiming  the  gravitation  of  bodies  on 
the  earth's  furface,  at  every  part  of  their  diurnal,  monthly,  and 
annual  periods  ;  and  which  might  facilitate  the  elucidation  of 
this  fubjecl.  But  I  am  well  aware  of  the  difficulty  of  its  appli- 
cation to  difeafes,  and  hope  thefe  conjectures  may  induce  oth- 
ers to  publiih  move  numerous  obfervations,  and  more  conclu- 
five  reafonings. 

SPECIES. 

I.  Somni  periodus.  The  periods  of  fleeping  and  of  waking 
are  (hortened  or  prolonged  by  fo  many  other  circumftances  in 
animal  life,  befides  the  minute  difference  between  diurnal  and 

nocturnal 


43»  DISEASES  CLASS  IV.  2. 4. 2- 

nocturnal  folar  gravitation,  that  it  can  fcarcely  be  afcribcd  to  this 
influence.  At  the  fame  time  it  is  curious  to  obferve,  that  veget- 
ables in  refpect  to  tfieir  times  of  fleeping  more  regularly  obferve 
the  hour  of  the  day,  than  the  prefence  or  abfence  of  light,  or  of 
heat,  as  may  be  feen  by  confuting  the  calendar  of  Flora.  Bo- 
tanic Garden,  Part  II.  Canto  2.  1.  165.  note. 

Some  difeafes,  which  at  firit  fight  might  be  fuppofed  to  be  in- 
fluenced by  folar  periods,  feem  to  be  induced  by  the  increafing 
fenfibility  of  the  fyftem  to  pain  during  our  fleeping  hours  ;  as 
explained  in  Sett.  XVIII.  15.  Of  thefe  are  the  fits  of  afthma, 
of  ibme  epilepfies,  and  of  fome  hsemoptoes  j  all  which  difturb 
the  patient  after  fome  hours  fleep,  and  are  therefore  to  be  af~ 
cribed  to  the  increafe  of  our  dormant  fenfibility.  There  may 
like  wife  be  fome  doubt,  whether  the  commencement  of  the  pain 
of  gout  in  the  foot,  as  it  generally  makes  its  attack  after  fleep, 
ihould  be  afcribed  to  the  increafed  fenfibility  in  fleep,  or  to  fo- 
lar influence  ? 

M.  M.  When  aflhmatic  or  epileptic  fits  or  hsemoptoe  occur 
after  a  certain  number  of  hours  of  fleep,  the  patient  mould  be 
forcibly  awakened  before  the  expected  time  by  an  alarm  clodcf 
and  drink  a  cup  of  chocolate  or  lemonade. — Or  a  grain  of  opi* 
um  mould  be  given  at  going  to  bed.-*-In  one  cafe  to  prevent 
the  too  great  increafe  of  fenfibility  by  mortening  the  time  of 
fleep  ;  and  in  the  other  by  increafing  the  irritative  motions,  and 
expending  by  that  means  a  part  of  the  fenforial  power. 

2.  Studii  inanis  periodus.     Clafs  III.  1.2.2.     The  cataleptic 
fpafm  which  preceded  the  reverie  and  fomnambulation  in  the 
patient,  whofe  cafe  is  related  in  Seel,  XIX.  2.  occurred  at  ex- 
atUy  the  fame  hour,  which  was  about  eleven  in  the  morning  for 
many  weeks  ;  till  thofe  periods  were  difturbed  by  large  dofes  of 
opium  ;  and  muft  therefore  be  referred  to  fome  effect  of  folar 
gravitation.     In  the  cafe  of  Mafter  A.  Sect.  XXXIV.  3.  as  the 
reverie  began  early  in  the  morning  during  fleep,  there  may  be  a 
doubt,  whether  this  commenced  with  torpor  of  fome  organ 
catenated  with  folar  gravitation ;  or  was  caufed  by  the  exift- 
ence  of  a  previous  torpid  part,  which  only  became  fo  painful  as 
to  excite  the  exertions  of  reverie  by  the  perpetual  increafe  of 
fenfibility  during  the  continuance  of  fleep,  as  in  forae  fits  of  epi- 
jepfy,  afthma,  and  hsemoptoe  mentioned  in  the  preceding  article. 

3.  Hemicranix  periodits*     Periods  of  Hemicrania.     Clafs  IV. 
2.  2.  8.     The  torpor  and  confequent  pain  of  fome  membranes 
on  one  fide  of  the  head,  as  over  one  eye,  are  frequently  occa- 
fioned  by  a  decaying  tooth,  and  are  liable  to  return  every  day, 
or  on  alternate  days  at  folar  or  lunar  periods.     In  this  cafe  large 
quantities  of  the  'bark  will  frequently  cure  the  difeafe,  and  ef- 

pecially 


CLASS  IV.  2.  4. 4.        OF  ASSOCIATION.  43 1 

pecially  if  preceded  by  venefection  and  a  briifc  cathartic  ;  but  i£ 
the  offending  tooth  can  be  detected,  the  mod  certain  cure  is  its 
extraction.  Thefe  partial  head-achs  are  alfo  liable  to  return  at 
the  greater  lunar  periods,  as  about  once  month.  Five  drops 
from  a  two-ounce  phial  of  a  faturated  folution  of  arfenic  twice 
a  day  for  a  week  or  two  have  been  faid  to  prevent  the  returns  of 
this  difeafe.  See  a  Treatife  on  Arfenic  by  Dr.  Fowler,  of  York. 
Strong  errhines  have  alfo  been  recommended. 

4.  Epilepfix  dolorifctf  periodus.     Chfs  III.  I.  I.  8.     The  pain 
which  induces  after  about  an  hour  the  violent  convulfions  or  in- 
fanity,  which  conftitute  the  painful  epilepfy,  generally  obferve 
folar  diurnal  periods  for  four  or  five  weeks,  and  are  probably 
governed  by  folar  and  lunar  times  in  refpect  to  their  greater  pe- 
riods ;  for  I  have  obferved  that  the  daily  paroxyfms,  unlefs  dif- 
turbed  by  large  dofes  of  opium,  recur  at  very  nearly  the  fame 
hour,  and  after  a  few  weeks  the  patients  have  recovered  to  re- 
lapfe  again  at  the  interval  of  a  few  months.     But  more  obfer- 
vations  are  wanted  upon  this  fubject,  which  might  be  of  great 
advantage  in  preventing  the  attacks  of  this  difeafe  ;  as  much  lefs 
opium  given  an  hour  before  its  expected  daily  return  will  pre* 
vent  the  paroxyfm,  than  is  necefTary  to  cure  it,  after  it  has  com- 
menced. 

5.  Convulftonis  dolerificx  periodus.     Clafs  III.  I.  I.  6;     The 
pains,  which  produce  thefe  convulfions,  are  generally  left  after 
rheumatifm,  and  come  on  when  the  patients  are  become  warm 
in  bed,  or  have  been  for  a  fliort  time  a  deep,  and  are  therefore 
perhaps  rather  to  be  afcribed  to  the  increafing  fenfibility  of  the 
fyftem  during  fleep,  than  to  foiar  diurnal  periods,  as  in  Species 
firft  and  fecond  of  this  Genus. 

6.  TuJJls  periodic*  periodus.     Periodic   cough,   Clafs  IV.  2.  r, 
9.  returns  at  exact  folar  periods ;  that  defcribed  in  Sect.  XXX\7T. 
3.  9.  recurred  about  feven  in  the  afternoon  for  feveral  weeks* 
till  its  periods  were  difturbed  by  opium,  and  then  it  recurred  at 
eleven  at  night  for  about  a  week,  and  was  then  totally  deftroy- 
ed  by  opium  given  in  very  large  quantities,  after  having  been 
previoufly  for  a  few  days  omitted. 

7.  Cat  amenta  periodus.     Periods  of  men  flruation.     The  cor- 
refpondence  of  the  periods  of  the  catameuia  with  thofe  of  the 
moon  was  treated  of  in  Sect*  XXXII.  6.  and  can  admit  of  no 
more  doubt,  than  that  the  returns  of  the  tides  are  governed  by- 
lunar  influence.     But  the  manner  in  which  this  is  produced,  k 
lefs  evident;  it  has  commonly  been  afcribed  to  feme  effect  of 
the  lunar  gravitation  on  the  circulating  blood,  as  mentioned  in 
Sect.  XXXII.  6..    But  it  is  .more  analogous  to  other  animal 
phenomena  to  fuppofe  that  the  lunar  gravl  lately 

ailed* 


43*  DISEASES  CLASS  IV.  2. 4.  & 

affefts  the  folids  by  its  influx  or  ftimulus.  Which  we  believe 
of  the  fluid  element  of  heat,  in  which  we  are  equally  immerfed ; 
and  of  the  electric  fluid,  which  alfo  furrounds  and  pervades  us. 
See  Sea.  XXXVI.  2.  3. 

If  the  torpor  of  the  uterine  veins,  which  induces  the  monthly 
periods  of  the  catamenia,  be  governed  by  the  increafe  of  terrene 
gravitation  ;  that  is,  by  the  deficiency  of  the  Counter-influence 
of  folar  and  lunar  gravitation  ;  why  does  not  it  occur  mod  fre- 
quently when  the  terrene  gravitation  is  the  greateft,  as  about  fix 
hours  after  the  new  moon,  and  next  to  that  at  about  fix  hours  after 
the  full  moon  ?  This  queflion  has  its  difficulty  -,  firft,if  the  ter- 
rene gravitation  be  greateft  about  fix  hours  after  the  new  moon,  it 
muft  become  lefs  and  lefs  about  the  fame  time  every  lunar  day, till 
the  end  of  the  firft  quarter,  when  it  will  be  the  leafl ;  it  muft  then 
increafe  daily  till  the  full.  After  the  full  the  terrene  gravitation 
muft  again  decreafe  till  the  end  of  the  third  quarter,  when  it  will 
again  be  the  leaft,  and  muft  increafe  again  till  the  new  moon  ; 
that  is,  the  folar  and  lunar  counter-gravitation  is  greateft,  when 
thofe  luminaries  are  vertical,  at  the  new  moon,  and  full  moon, 
and  leaft  about  fix  hours  afterwards.  If  it  was  known,  wheth- 
er more  menftruations  occur  about  fix  hours  after  the  moon  is 
in  the  zenith  or  nadir  •,  and  in  the  fecond  and  fourth  quarters  of 
the  moon,  than  in  the  firft  and  third  ;  fome  light  would  be 
thrown  on  this  fubjeft  ;  which  muft  in  that  refpe£l  wait  for 
future  obfervations. 

Secondly,  if  the  lunar  influence  produces  a  very  fmall  degree 
of  quiefcence,  fuppofe  of  the  uterine  veins,  at  firft  ;  and  if  that 
recurs  at  certain  periods,  as  of  lunar  days,  or  about  25  hours, 
even  with  lefs  power  to  produce  quiefcence  than  at  firft  ;  yet 
the  quiefcence  will  daily  increafe  by  the  acquired  habit  acting 
at  the  fame  time,  as  explained  in  Sect.  XII.  3.  3.  till  at  length 
fo  great  a  degree  of  quiefcence  will  be  induced  as  to  caufe  the 
inaction  of  the  veins  of  the  uterus,  and  confequent  venous  haem- 
orrhage. See  Se£l.  XXXII.  6.  Clafs  I.  2.  i.  n.  IV.  i.  4.  4. 
See  the  introduaion  to  this  Genus. 

8.  Hamorrhoidis  periodus.     The  periods  of  the   piles  depend 
on  the  torpor  of  the  veins  of  the  reaum,  and  are  believed  to  re- 
cur nearly  at  monthly   intervals.     See   Sea.  XXVII.  2.  and 
Clafs  I.   2.    i.  6. 

9.  Podagra  periodus.     The  periods  of  gout  in  fome  patients 
recur  at  annual  intervals,  as  in  the  cafe  related  above  in  Clafs 
IV.   i.  2.   15.  in  which  the  gouty  paroxyfm  returned  for  three 
fucceflive   years  on  nearly  the  fame  day  of  the  month.     The 
commencement  of  the  pain  of  each  paroxyfm  is  generally  a  few 
hours  after  midnight,  and  may  thence  either  be  induced  by  di- 
urnal 


CLASS  IV.  2. 4. 10.       OF  ASSOCIATION.  433 

urnal  folar  periods,  or  by  the  increafing  fenfibility  during  fleep, 
as  mentioned  in  the  firil  fpecies  of  this  genus. 

10.  Eryftpelatis  periodus.     Some  kinds    of  eryfipelas   which 
probably  originate  from  the  aflbciation  of  the  cutaneous  veflels 
with  a  difeafed  liver,  occur'- at  monthly  periods,  like  the  hssmor- 
rhois  or  piles  ;   and  others  at  annual  periods,  like  the  gout ;  as  a 
torpor  of  fome  part  I  fuppofe  always  precedes  the  eryfipelatous 
inflammation,  the  periods  fhould  accord  with  the  increafing  in- 
fluence of  terrene  gravitation,  as  defcribed  in  the  introduction  to 
this  Genus,  and  in  fpecies  the  feventh  of  it.     Other  periods  of 
difeafes  referable  to  folar  and  lunar  influence  are   mentioned  in 
Section  XXXVI.  and  many  others  will  probably  be  difcovered 
by  future  obfervation. 

11.  Febrtum  periodus.     Periods  of  fevers.     The  commence- 
ment of  the  cold- 'fits  of  intermittent  fevers,  and  the  daily  exa- 
cerbations of  other  fevers,  fo  regularly  recur  at  diurnal  folar  or 
lunar   periods,  that  it  is  impoffible  to  deny  their  connection  with 
gravitation  ;  as  explained  in  Seel,   XXXVI.    3.     Not  only  thefe 
exacerbations  of  fever,  and  their  remiflions,  and  the  diurnal  fo- 
lar and  lunar  periods  ;  but  the  preparatory  circumftances,  which 
introduce  fevers,  or  which  determine  their  crififes,  appear  to  be 
governed  by  the  parts  of  monthly  lunar  periods,  and   of  folar 
annual  ones.     Thus    the  variolous   fever  in  the  natural  fmall- 
pox  commences  on  the  I4th  day,  and  in  the  inoculated  fmall- 
pox  on  the  feventh  day.     The  fever  and  etuption  in  the  diftinct 
kind  take  up  another  quarter  of  a  lunation,  and  the  maturation 
another  quarter. 

The  fever,  which  is  termed  canine  madnefs  or  hydrophobia, 
is  believed  to  commence  near  the  new  or  full  moon  ;  and,  if  the 
caufe  is  not  then  great  enough  to  bring  on  the  difeafe,  it  feems 
to  acquire  fome  ftrength,  or  to  lie  dormant,  till  another,  or  per- 
haps more  powerful  lunation  calls  it  into  action.  In  the  fpring, 
about  three  or  four  years  ago,  a  mad  dog  very  much  worried  one 
fwine  confined  in  a  fly,  and  bit  another  in  the  fame  ity  in  a  lefs 
degree  ;  the  former  became  mad,  refufed  his  meat,  was  much 
convulfed,  and  died  in  about  four  days  ;  this  difeafe  commenced 
about  a  month  after  the  bite.  The  other  fwine  began  to  be  ill 
about  a  month  after  the  firft,  and  died  in  the  fame  manner, 


VOL,  II.  H  H  h  ORDO 


434  DISEASES  CLASS  IV.  3.  i. 

ORDO  III. 

Retrograde  Affociate  Motions. 
GENUS  I. 

4 

Catenated  •with  Irritative  Motions. 

THOSE  retrograde  aflbciate  motions,  the  fir  ft  links  of  which 
are  catenated  with  irritative  motions,  belong  to  this  genus.  All 
the  retrograde  motions  are  confequent  to  debility,  or  inactivity, 
of  the  organ  ;  and  therefore  properly  belong  to  the  genera  of  de- 
creafed  actions  both  in  this  and  the  former  clafles. 

SPECIES. 

1.  Diabetes  irritata.     When  the  abforbents  of  the  inteftines 
are  ftimulated  too  ftrongly  by  fpirit  of  wine,  as  in  the  beginning 
of  drunkennefs,  the  urinary  abforbents  invert  their  motions. 
The  fame  happens  from  worms  in  the  inteftines.     In  other 
kinds  of  diabetes  may  not  the  remote  caufe  be  the  too  ftrong 
action  of  the  cutaneous  abforbents,  or  of  the  pulmonary  ones  r 
May  not  in  fuch  cafes  oil  externally  or  internally  be  of  fervice  ? 
or  warm  bathing  for  an  hour  at  a  time  ?  In  hyfteric  inverfions 
of  motion  is  fome  other  part  too  much  ftimulated  ?  or  pained 
from  the  want  of  ftimulus  ? 

2.  Sudor  frigidus  in  ajthmate.     The  caufe  of  the  paroxyfms  of 
humoral  afthma  is  not  well  underftood  ;  I  fuppofe  it  to  be  ow- 
ing to  a  torpidity  or  inaction  of  the  abforbents  belonging  to  the 
pulmonary  veffels,  as  happens  probably  to  other  vifcera  at  the 
commencement  of  intermittent  fevers,  and  to  a  confequent  ac- 
cumulation of  fluids  in  them  ;  which  at  length  producing  great 
irritation  or  uneafy  fenfation  caufes  the  violent  efforts  to  pro- 
duce the  abforption  of  it.     The  motions  of  the  cutaneous  ab- 
forbent  veflels  by  their  aflbciation  with  thofe  of  the  pulmonary 
ones  become  retrograde,  and  effufe  upon  the  fkin  a  fluid,  which 
is  faid  to  be  vifcid,  and  which  adheres  in  drops. 

A  few  days  ago  I  faw  a  young  man  of  delicate  conftitution  in 
what  was  called  a  fit  of  the  afthma ;  he  had  about  two  months 
before  had  a  periprieumony,  and  had  been  ever  fmce  fubject  to 
difficult  refpiration  on  exertion,  with  occafional  palpitation  of 
his  heart.  He  was  now  feized  about  eight  at  night  after  fome 
exertion  of  mind  in  his  bufinefs  with  cold  extremities,  and  diffi- 
culty of  breathing.  He  gradually  became  worfe,  and  in  about 

half 


CLASS  IV.  3.  i.  3.       OF  ASSOCIATION.  435 

half  an  hour,  the  palpitation  of  his  heart  and  difficult  refpiration 
were  very  alarming  ;  his  whole  (kin  was  cold  and  pale,  yet  he 
did  not  (h udder  as.  in  cold  paroxyfm  of  fever ;  his  tongue  from 
the  point  to  the  middle  became  as  cold  as  his  other  extremities, 
with  cold  breath.  He  feemed  to  be  in  the  act  of  dying,  except 
that  his  pulfe  continued  equal  in  time,  though  very  quick.  He 
loft  three  ounces  of  blood,  and  took  ten  drops  of  laudanum,  with 
muflc  and  fait  of  hartftiorn,  and  recovered  in  an  hour  or  two 
without  any  cold  fweat. 

There  being  no  cold  fweat  feems  to  indicate,  that  there  was 
no  accumulation  of  ferous  fluid  in  the  lungs  j  and  that  their 
inactivity,  and  the  coldneis  of  the  breath,  was  owing  to  the 
fympathy  of  the  air-cells  with  fome  diftant  part.  There  was 
no  muddering  produced,  becaufe  the  lungs  are  not  fenfible  to 
heat  and  cold  ;  as  any  one  may  obferve  by  going  from  a  warm 
room  into  a  frofty  air,  and  the  contrary.  So  the  fteam  of  hot 
tea,  which  fcalds  the  mouth,  does  not  affect  the  lungs  with  the 
fenfation  of  heat.  I  was  induced  to  believe  that  the  whole  cold 
fit  might  be  owing  to  fuppuration  in  fome  part  of  the  cheft  ;  as 
the  general  difficulty  of  breathing  feemed  to  be  increafed  after  a 
few  days  with  pulfe  of  1 20,  and  other  figns  of  empyema.  Do 
the  cold  fweat,  and  the  occurrence  of  the  fits  of  afthma  after 
fleep,  diftinguifh  the  humoral  afthma  from  the  cold  paroxyfm  of 
intermittents,  or  that  which  attends  fuppuration,  or  which  pre- 
cedes inflammation  ?— I  heard  a  few  weeks  afterwards,  that  he 
fpit  up  much  matter  at  the  time  he  died. 

3.  Diabetes  a  timore.     The  motions  of  the  abforbent  veflels  of 
the  neck  of  the  bladder  become  inverted  by  their  confent  with 
thofe  of  the  fkin  ;  which  are  become  torpid  by  their  reverfe 
fympathy  with  the  painful  ideas  of  fear,  as  in  Sect.  XVI.  8.  I. 
whence  there  is  a  great  difcharge  of  pale  urine,  as  in  hyfteric 
difeafes. 

The  fame  happens  from  anxiety,  where  the  painful  fufpenfe 
is  continued,  even  when  the  degree  of  fear  is  fmall ;  as  in  young 
men  about  to  be  examined  for  a  degree  at  the  univerfities  the 
frequency  of  making  water  is  very  obfervable.  When  this  anxi- 
ety is  attended  with  a  fleeplefs  night,  the  quantity  of  pale  urine  is 
amazingly  great  in  fome  people,  and  the  micturition  very  fre- 
quent. 

M.  M.  Opium.     Joy.     Confolations  of  friendfhip. 

4.  Diarrhoea  a  timore.    The  abforbent  veflels  of  the  inteftines 
invert  their  motions  by  direct  confent  with  the  (kin  ;  hence 
many  liquid  (tools  as  well  as  much  pale  urine  are  liable  to  ac- 
company continued  fear,  along  with  coldnefs  of  the  (kin.     The 
immediate  cauie  of  this  is  the  decreafed  fenforial  power  of  afib- 

ciation, 


436  DISEASES  CLASS  IV.  3.  i.  5. 

elation,  which  intervenes  between  the  aaions  of  the  abforbents 
of  the  cold  fkin,  and  thofe  of  the  inreitinal  abforbents  ;  the  mo- 
tions of  the  latter  become  on  that  account  weakened  and  at 
length  retrograde.  The  remote  caufe  is  theSfcorpor  of  the  vef- 
fels  of  the  fkin  catenated  with  the  pain  of  fear,  as  explained  in 
Sea.  XVI.  8.  i. 

The  capillaries  of  the  fkin  confent  more  generally  by  direct 
fympathy  with  thofe  of  the  lower  inteftines,  and  of  the  bladder ; 
but  by  reverie  fympaihy  more  generally  with  thofe  of  the  ftom- 
ach  and  upper  inteftines.  As  appears  in  fevers,  where  the  hot 
fkin  accompanies  indigeftion  of  the  fiomach  ;  and  in  diarrhoeas 
attended  with  cold  extremities. 

The  remote  caufe  is  the  torpor  of  the  fkin  owing  to  its  reverfe 
fympathy  with  the  painful  fenfual  motions,  or  ideas,  of  fear  ; 
which  are  now  actuated  with  great  energy,  fo  as  to  deprive  the 
fecond  link  of  aflbciaced  motions  of  their  due  (hare  of  fenforial 
power.  It  is  alfo  probable,  that  the  pain  of  fear  itfelf  may  con- 
tribute to  exhauft  the  fenforial  power,  even  when  it  produces  nq 
mufcular  action.  See  Clafs  IV.  2.  2. 

5.  Pallor  et  tremor  a  timore.  A  retrograde  action  of  the  ca- 
pillaries of  the  fkin  producing  palenefs,  and  a  torpor  of  the  muf- 
cular fibres  of  the  limbs  occafioning  trembling,  are  caufed  by 
their  reverfe  afTc.  htions  with  the  ideas  or  imaginations  of  fear ; 
which  are  now  aciuatci:  h  violent  energy,  and  accompanied 
with  great  pain.  The  caufe  of  thefe  aflbciations  are  explained 
in  Sea.  XVI.  8.  i. 

Thefe  torpid  aaions  of  the  capillaries  and  mufcles  of  the 
limbs  are  not  caufed  immediately  by  the  painful  fenfation  of 
fear  j  as  in  that  cafe  they  would  have  been  increafed  and  not 
clecreafed  aaions,  as  occurs  in  anger  ;  where  the  painful  voli- 
tion increafes  the  aaions  of  the  capillaries,  exciting  a  blufh  and 
heat  of  the  fkin.  Whence  we  may  gain  fome  knowledge  of 
what  is  meant  by  deprcfTing  and  exciting  paffions ;  the  former 
confifting  of  ideas  attended  with  pain,  which  pain  occafions  no 
mufcular  aaions,  like  the  pain  of  cold  head-ach ;  the  latter  be- 
ing attended  with  volitions,  and  confequent  mufcular  exertions. 

That  is,  the  pain  of  fear,  and  the  pain  of  anger,  are  produced 
by  the  exertion  of  certain  ideas,  or  motions  of  certain  nerves  of 
fenfe  ;  in  the  former  cafe  the  painful  fenfation  of  fear  produces 
no  mufcular  aaions,  yet  it  exhaufis  or  employs  fo  much  fenforial 
power,  that  the  whole  fyftem  aas  more  feebly,  or  becomes 
retrograde  ;  but  fome  parts  of  it  more  fo  than  others,  according 
to  their  early  aflbciahons  defcribed  in  Sea.  XVI.  8.  i.  hence 
the  tremor  of  the  limbs,  palpitation  of  heart,  and  even  fyncope. 
In  anger  the  painful  volition  produces  violent  mufcular  aaions  *, 

but 


CLASS  IV.  3.  i.  6.        OF  ASSOCIATION.  43  7 

but  if  previous  to  thefe  any  deliberation  occurs,  a  flufhed  co.  i- 
tenance  fometimes,  and  a  red  fkin,  are  produced  by  this  fupera- 
bundance  of  volition  exerted  on  the  arterial  tyftem  ;  but  at  oth- 
er times  the  (kin  becomes  pale,  and  the  legs  tremble,  from  the 
exhauftion  or  expenditure  of  the  fenforial  power  by  the  painful 
'volitions  of  anger  on  the  organs  of  fenfe,  as  by  the  painful  fen- 
fations  of  fear  above  mentioned. 

Where  the  paffion  of  fear  exifts  in  a  great  degree,  it  exhaufts 
or  expends  fo  much  fenforial  power,  either  fimply  by  the  pain 
which  attends  it,  or  by  the  violent  and  perpetual  excitement  of 
the  terrific  imaginations,  or  ideas,  that  not  only  a  cold  and  pale 
fkin,  but  a  retrograde  motion  of  the  cutaneous  abforbents  oc- 
curs, and'a  cold  fweat  appears  upon  the  whole  furface  of  the 
body,  which  probably  fometimes  increafes  pulmonary  abforp- 
tion;  as  in  Clafs  II.  i.  6.  4.  and  as  in  the  cold  fweats,  which 
attend  the  paroxyfms  of  humoral  afthma.  Hence  anxiety, 
which  is  a  continued  pain  of  fear,  fo  univerfally  debilitates  the 
conftitution  as  to  occafion  a  lingering  death  ;  which  happens 
much  more  frequently  than  is  ufually  fuppofed ;  and  thefe  vie-* 
tims  of  continued  anxiety  are  faid  to  die  of  a  broken  heart. 
Other  kinds  of  palenefs  are  defcribed  in  Clafs  I.  2.  2.  2. 

M.  M.  Opium.     Wine.     Food.     Joy. 

6.  Palpjtatio  cordis  a  timore.  The  palpitation  of  the  heart 
from  fear  is  owing  to  the  weak  adlion  of  it,  and  perhaps  fome- 
times to  the  retrograde  exertion  of  the  ventricles  and  auricles  \ 
becaufe  it  ieems  to  be  affected  by  its  afibciation  with  the  capil- 
laries, the  actions  of  which,  with  thofe  of  the  arteries  and  veins, 
conftitute  one  great  circle  of  ailbciate  motions.  Now  when 
the  capillaries  of  the  (kin  become  torpid,  coldnefs,  and  palenefs 
fucceed;  and  with  thefe  are  aflbciated  the  capillaries  of  the 
lungs,  whence  difficult  refpiration  ;  and  with  thefe  the  weak 
and  retrograde  actions  of  the  heart.  At  the  fame  time  the  ab- 
forbents of  the  fkin,  and  of  the  bladder,  and  of  the  inteltines, 
fometimes  become  retrograde,  and  regurgitate  their  contents ; 
as  appears  by  the  pale  urine  in  large  quantities,  which  attends 
hyfteric  complaints  along  with  this  palpitation  of  the  heart  j 
and  from  the  cold  fweats,  and  diarrhoea  •,  all  which,  as  well  as 
the  hyfteric  complaints,  are  liable  to  be  induced  or  attended  by 
fear.  f 

When  fear  has  ftill  more  violently  affected  the  fyftem,  there 
have  been  inftances  where  fyncope,  and  fudden  death,  or  a  total 
itoppage  of  the  circulation  have  fucceeded :  in  thefe  laft  cafes, 
the  pain  of  fear  has  employed  or  exhaufted  the  whole  of  the 
fenforial  power,  fo  that  not  only  thole  mufcular  fibres  generally 
exerted  by  volition  ceafe  to  act,  whence  the  patient  falls  down ; 

and 


438  DISEASES  CLASS  IV.  3, 


and  thofc  which  conftitute  the  organs  of  fenfe,  whence  fynco- 
pe ;  but  laftly  thofe,  which  perform  the  vital  motions,  become 
deprived  of  fenforial  power,  and  death  enfues.  See  Clafs  I.  2. 
I.  4.  and  I.  2.  I.  10.  Similar  to  this  in  fome  epileptic  fits  the 
patient  firft  fuddenly  falls  down,  without  even  endeavouring  to 
fave  himfelf  by  his  hands  before  the  convulfive  motions  come 
on.  In  this  cafe  the  great  exertion  of  fome  fmall  part  in  confe- 
quence  of  great  irritation  or  fenfation  exhaufts  the  whole  fen- 
forial power,  which  was  lodged  in  the  extremities  of  the  lo- 
comotive nerves,  for  a  (hort  time,  as  in  fyncope  ;  and  as 
foon  as  thefe  mufcles  are  again  fupplied,  convulfions  fuper- 
vene  to  relieve  the  painful  fenfation.  See  Clafs  III.  i%  i.  7. 

7.  Abortio  a  timore.     Women  mifcarry  much  more  frequent- 
ly from  a  fright,  than  from  bodily  injury.     A  torpor  or  retro- 
grade motion  of  the  capillary  arteries  of  the  internal  uterus  is 
probably  the  immediate  caufe  of  thefe  mifcarriages,  owing  to 
the  affociation  of  the  actions  of  thofe  veflels  with  the  capillaries 
of  the  fkin,  which  are  rendered  torpid  or  retrograde   by  fear. 
By  this  contraction  of  the  uterine  arteries,  the  fine  veflels  of 
the  placenta,  which  are  inferred  into  them,  are  detruded,  or  oth- 
erwife  fo  affected,  that  the  placenta  feparates  at  this  time  from 
the  uterus,   and  the ,  fetus  dies    from   want  of  oxygenation. 
A  flrong  young  woman,  in  the  fifth  or  fixth  month  of  her  preg- 
nancy, who  has  fince  borne  many  children,  went  into  her  cellar 
to  draw  beer  ;  one  of  her  fervant  boys  was  hid  behind  a  bar- 
rel, and  darted  out  to  furprife  her,  believing  her  to  be  the 
maid-fervant ;  fhe  began  to  flood  immediately,  and  mifcarried 
in  a  few  hours.     See  Se&.  XXXIX.  6.  5.  and  Clafs  I.  2.  i.   14. 

8.  Hyfterla  a  timore.     Some  delicate  ladies  are  liable  to  fall 
into  hyfteric  fits  from  fudden  fright.     The  periftaltic  motions 
of  the  bowels  and  ftomach,  and  thofe  of  the  cefophagus,  make 
n  part  of  the  great  circle  of  irritative  motions  with  thofe  of  the 
ikin,  and  many  other  membranes.   ^Hence  when  the  cutaneous 
veflels  become  torpid  from  their  reverfe  fympathy  with  the 
painful  ideas  of  fear ;  thofe  of  the  bowels,  and  ftomach,  and 
osfophagus,  become  firft  torpid  by  direct  fympathy  with  thofe 
of  the  flun,  and  then  feebly  and  ineffectually  invert  the  order  of 
their  motions,  which  conftitutes  a  paroxyfm  of  the  hyfteric  dif- 
eafe.     See  Clafs  I.  3.   1.    10.     Thefe  hyfteric  paroxyfms  are 
fometimes  followed  by  convulfions,  which  belong  to  Clafs  III. 
as  they  are  exertions  to  relieve  pain ;  and  fometimes  by  death. 
See  Species  9.  of  this  Genus,  and  Clafs  I.  2.  I.  4. 

Indigeftion  from  fear,  is  to  be  afcribed  in  the  fame  manner 
to  the  torpor  of  the  ftomach,  owing  to  its  aflbciation  with  the 
ikin.  As  in  Clafs  IV.  I.  2.  5.  IV.  2.  I. 

ORDO 


. 

nco- 


CLASS  IV.  3. 2.  i.      OF  ASSOCIATION.  439 

ORDO  III. 

Retrograde  AJJbciate  Motions* 

GENUS  II. 
Catenated  •with  Sen/it  we  Motions. 

SPECIES. 

1.  Naufea  idealls.      Naufea  from  difguftful  ideas,  as  from 
tiaufeous  ftories,  or  difguftful  fights,  or  fmells,  or  taftes,  as  well 
as  vomiting  from  the  fame  caufes,  confifts  in  the  retrograde  ac- 
tions of  the  lymphatics  of  the  throat,  and  of  the  cefophagus,  and 
flomach ;  which  are  afibciated  with  J:he  difguftful  ideas,  or  fen- 
fual  motions  of  fight,  or  hearing,  or  fmell,  or  tafte ;  for  as  thefc 
are  deareafed  motions  of  the  lymphatics,  or  of  the  cefophagus,  or 
flomach,  they  cannot  immediately  be  excited  by  the  fenforial 
power  of  painful  fenfation,  as  in  that  cafe  they  ought  to  be  in- 
creafed  motions.     So  much  fenforial  power  is  employed  for  a 
time  on  the  difguftful  idea,  or  expended  in  the  production  of 
inactive  pain,  which  attends  it,  that  the  other  parts  of  the  aflb- 
ciated chain  of  action,  of  which  this  difguftful  idea  is  now  be- 
come a  link,  are  deprived  of  their  accuftomed  fhare  ;  and  there- 
fore firft  ftop,  and  then  invert  their  motions.     Owing  to  defi« 
ciency  of  fenforial  power,  as  explained  more  at  large  in  Seel. 

xxxv.  i.  3. 

2.  Naufea  a  conceptu.     The  naufea,  which  pregnant  women 
are  fo  fubjecl:  to  during  the  firft  part  of  geftation,  is  owing  to 
the  reverfe  fympathy  between  the  uterus  and  ftomach,  fo  that 
the  increafed  action  of  the  former,  excited  by  the  ftimulus  of 
the  growing  embryon,  which  I  believe  is  fometimes  attended 
with  fenfation,  produces  decreafed  actions  of  the  latter  with  the 
difagreeable  fenfation  of  ficknefs  with  indigeftion  and  confe- 
quent  acidity.     When  the  fetus  acquires  fo  much  mufcular 
power  as  to  move  its  limbs,  or  to  turn  itfelf,  which  is  called 
quickening,  this  ficknefs  of  pregnancy  generally  ceafes. 

M.  M.  Calcined  magnefia.     Rhubarb.     Half  a  grain  of  opi- 
um twice  a  day.     Recumbent  pofture  on  a  fofa. 

3.  Vomitio  ijcrtiginofa.     Sea^ficknefs,  the  irritative  motions  of 
vifion,  by  which  we  balance  ourfelves,  and  preferve  our  perpen- 
dicularity, are  difturbed  by  the  indiftinclnefs  of  their  objeas  ; 
Which  is  either  owing  to  the  fimilarity  of  them,  or  to  their  dif- 

tance, 


DISEASES  CLASS  IV.  3. 2. 4, 

tance,  or  to  their  apparent  or  unufual  motions.  Hence  thefe 
irritative  motions  of  vifion  are  exerted  with  greater  energy,  and 
are  in  confequence  attended  with  fenfation  ;  which  at  firft  is 
agreeable,  as  when  children  fwing  on  a  rope  ;  afterwards  the 
irritative  motions  of  the  ftomach,  and  of  the  abforbent  veflels, 
which  open  their  mouths  into  it,  become  inverted  by  their  af- 
fociations  with  them  by  reverfe  fympathy. 

For  the  action  of  vomiting,  as  well  as  the  difagreeable  fen- 
fation of  ficknefs,  are  mewn  to  be  occafioned  by  defect  of  the 
fenforial  power  5  which  in  this  cafe  is  owing  to  the  greater  ex- 
penditure of  it  by  the  fenfe  of  vifion.  On  the  fame  account  the 
vomiting,  which  attends  the  pafl~age*of  a  (tone  through  the  ure- 
ter, or  an  inflammation  of  the  bowels,  or  the  commencement  of 
fome  fevers,  is  cuufed  by  the  increafed  expenditure  of  the  fen-"" 
forial  power  by  the  too  great  action  of  fome  links  of  the  aflbci- 
ations  of  irritative  motions ;  and  there  being  in  confequenoe  a 
deficiency  of  the  quantity? required  for  other  links  of  this  great 
catenation. 

It  muft  be  obferved,  that  the  expenditure  of  fenforial  power 
by  the  retinas  of  the  eyes  is  very  great ;  which  may  be  efdmated 
by  the  perpetual  ufe  of  thofe  organs  during  our  waking  hours, 
and  during  moft  of  our  fleeping  ones  ;  and  by  the  large  diam- 
eters of  the  two  optic  nerves,  which  are  nearly  the  fize  of  a 
quill,  or  equal  to  fome  of  the  principal  nerves,  which  ferve  the 
limbs. 

4.  Vomitio  a  calculo  in  uretere.  The  action  of  vomiting  in  con- 
fequence of  the  increafed  or  decreafed  actions  of  the  ureter, 
when  a  ftone  lodges  in  it.  The  natural  actions  of  the  ftomach, 
which  confift  of  motions  fubject  to  intermitted  irritations  from 
the  fluids,  which  pafs  through  it,  are  aflbciated  with  thofe  of  the 
ureter  \  and  become  torpid,  and  confequently  retrograde,  by  in- 
tervals, when  the  actions  of  the  ureter  become  torpid  owing  to 
previous  great  flimulus  from  the  ftone  it  contains;  as  appears 
from  the  vomiting  exifting  when  the  pain  js  leaft.  When  the 
motions  of  the  ureter  are  thus  leflened,  the  fenforial  power  of 
aflbciation,  which  ought  to  actuate  the  ftomach  along  with  the 
•fenforial  power  of  irritation,  ceafes  to  be  excited  into  action ; 
and  in  confequence  the  actions  of  the  ftomach  become  lefs  en- 
ergetic, and  in  confequence  retrograde. 

For  as  vomiting  is  a  decreafed  action  of  the  ftomach,  as  ex- 
plained in  Sect.  XXXV.  i.  3.  it  cannot  be  fuppofed  to  be 
produced  by  the  pain  of  gravel  in  the  ureter  alone,  as  it  fhould 
then  be  an  increafed  action,  not  a  decreafed  one. 

The  perpetual  vomiting  in  ileus  is  caufed  in  like  manner  by 
the  defective  excitement  of  the  fenforial  power  of  aflbciation  by 

the 


CLASS  IV.  3.2.5.       OF  ASSOCIATION.  441 

-- 

the  bowel,  which  is  torpid  during  the  intervals  of  pain  j  and  the 
ftomach»fympathizes  with  it.  See  Enteritis, Clafs II.  i.  2.  u* 
Does  this  fymptom  of  vomiting  indicate,  whether  the  difeafe  be 
above  or  below  the  valve  of  the  colon  ?  Does  not  the  fofter 
pulfe  in  fome  kinds  of  enteritis  depend  on  the  fympathy  of  the 
heart  and  arteries  with  the  ficknefs  of  the  ftomach  ?  See  Ileus 
and  Cholera. 

Hence  this  ficknefs,  as  well  as  the  ficknefs  in  fome  fevers^ 
cannot  be  efteemed  an  effort  of  nature  to  diflodge  any  offenfive 
material ;  but  like  the  fea-ficknefs  defcribed  above,  and  in  Sect. 
XX.  4.  is  the  confequence  of  the  affociations  of  irritative  or  fen- 
fitive  motions.  See  Clafs  I.'  i.  3.  9. 

5.  Vomitio  ab  infultu  paralytico.     Paralytic  affections  generally 
'commence  with  vomiting,-  the  fame  frequently  happens  from  a 
violent  blow  with  a  flick  on  the  head ;  this  curious  connection 
of  the  brain  and  ftomach  has  not  been  explained  ;  as  it  refem- 
bles  the  ficknefs  in  confequence  of  vertigo  at  fea,  it  would  feern. 
to  arife  from  a   fimilar  caufe,  viz.  from  difturbed  irritative  or 
fenfitive  affociations. 

6.  Vomitio  a  titillatlone  faucium.     If  the  throat  be  fiightly  tick- 
led with  a  feather,  a  naufea  is  produced,  that  is,  an  inverted  ac- 
tion of  the  mouths  of  the  lymphatics  of  the  fauces,  and  by  di- 
rect fympathy  an  inverted  action  of  the  ftomach  eiifues.     As 
thefe  parts  have  frequently  been  ftimulated  at  the  fame  time  in- 
to pleafurable   action  by  the  deglutition  of  our  daily  aliment, 
their  aclions  become  ftrongly  affociated.     And   as  all  the  food 
we  fwallow,  is  either  moift  originally  or  mixed  with  our  moift 
faliva  in  the  mouth ;    a  feather,    which  is  originally  dry,  and 
which  in  fome  meafure  repels  the  moift  faliva,  is  difagreeable  to 
die  touch  of  the  fauces ;  at  the  fame  time  this  naufea  and  vom- 
iting cannot  be  caufed  by  difagreeable  fenfation  fimply,  as  then 
they  ought  to  have  been  increafed  exertions,  and  not  decreafed 
ones,  as  (hewn  in  Section  XXXV.  1.3.     But  the  mouths  of  the 
lymphatics  of  the  fauces  are  ftimulated  by  the  dry  feather  into 
too  great  action  for  a  time,  and  become  retrograde  afterwards 
by  the  debility  confequent  to  too  great  previous  ftimulus. 

7.  Vomitio  cute  fympaihetica.     Vomiting  is  fuccefsfully  flopped 
by  the  application  of  a  blifter  on  the  back  in  fome  fevers,  where 
the  extremities  are  cold,  and  the  fkin  pale.     It  was  flopped  by 
Sydenham  by  producing  a   fweat  on  the  {kin  by  covering  the 
head  with  the  bedclothes.     See  Clafs  IV.   i,    i.  3.  and  SuppL 
I.    if.  6. 


VOL.  II.  1 1  i  ORDO 


442  DISEASES  CLASS  IV.  3*  3.  i, 

ORDO  III. 

Retrograde  Affociate  Motions. 

GENUS  III. 

Catenated  with  Voluntary  Motions. 
SPECIES. 

1.  Rwninatio.     In  the  rumination  of  horned  cattle  the  food  i 
brought  up  from  the  firft  ftomach  by  the  retrograde  motions  of 
the  ftomach  and  cefophagus,  which  are  catenated  with  the  vol- 
untary motions  of  the  abdominal  mufcles. 

2.  Vomitio  'uoluntana.     Voluntary  vomiting.     Some  human 
fubjects  have  been  faid  to  have  obtained  this  power  of  volunta- 
ry action  over  the  retrograde  motions  of  the  ftomach  and  cefoph- 
agus, and  thus  to  have  been  able  to  empty   their  ftomach  at 
pleafure.     See  Sect.  XXV.  6.     This  voluntary  act  of  empty- 
ing the  ftomach  is  poflefled  by  fome  birds,  as  the  pigeon  ;  who 
has  an  organ  for  fecreting  milk  in  its  ftomach,  as  Mr.  Hunter 
obferved  j  and  foftens  the  food  for  its  young  by  previoufly  fwal- 
lowing  it ;  and  afterwards  putting  its  bill  into  theirs  returns  it 
into  their  mouths.     See  Sect.  XXXIX.  4.  8.     The  pelicans  ufe 
a  ftomach,  or  throat  bag,  for  the  purpofe  of  bringing  the  fifli, 
which  they  catch  in  the  fea  to  (hore,  and  then  eject  them,  and 
eat  them  at  their  leifure.     See  Sect.  XVI.  1 1.     And  I  am  well 
informed  of  a  bitch,  who  having  puppies  in  a  ftable  at  a  diftance 
from  the  houfe,  fwallowed  the  flem-meat,  which  was  given  her, 
in  large   pieces,  and  carrying  it  immediately  to  her  whelps, 
brought  it  up  out  of  her  ftomach,  and  laid  it  down  before  them. 

3.  Eruflatio  voluntaria.     Voluntary  eructation.     Some,  who 
have  weak  digeftions,  and  thence  have  frequently  been  induced 
to  eruct  the  quantity  of  air  difcharged  from  the  fermenting  ali- 
ment in  their  ftomachs,  have  gradually  obtained  a  power  of  vol- 
untary eructation,  and  have  been  able  thus  to  bring  up  hogf- 
heads  of  air  from  their  ftomachs  whenever  they  pleafed.     This 
great  quantity  of  air  is  to  be  afcribed  to  the  increate  of  the  fer- 
mentation of  the  aliment  by  drawing  off  the  gas  as  foon  as  it  i» 
produced.    See  Sea.  XXIII.  4. 


ORDO 


CLASS  IV.  3. 4.  i.      OF  ASSOCIATION.  443 

ORDO  HI. 

Retrograde  Affbciate  Motions, 

GENUS  IV. 

Catenated  with  External  Influences* 
SPECIES. 

1 .  Catarrhus  periodicus.     Periodical  catarrh  is  not  a  very  un- 
common difeafe;  there  is  a  great  difcharge  of  a  thin  faline  mu- 
cous material  from  the  membranes  of  the  noftrils,  and  probably 
from  the  maxillary  and  frontal  fmufes,  which  recur  once  a  day 
at  exacl  folar  periods  ;    unlefs  it  be  difturbed   by  exhibition 
of  opium-,  andrefembles  the. periodic  cough  mentioned  below. 
See  Clafs  I.  3.  2.  i.     It  is  probably  owing  to  the  retrograde  ac- 
tion of  the  lymphatics  of  the  membranes  affected,  and  produced 
immediately  by  folar  influence. 

2.  Tuffis  periodica.     Periodic  cough,  called   nervous  cough, 
and  tuflis  ferina.     It  feems  to  arife  from  a  periodic  retrograde 
action  of  the  lymphatics  of  the  membrane,  which  lines  the  air- 
cells  of  the  lungs.     And  the  action  of  coughing,  which  is  vio- 
lent for  an  hour  or  longer,  is  probably  excited  by  the  ftimulus 
of  the  thin  fluid  thus  produced,  as  well  as  by  the  difagreeable 
fenfation  attending  membranous  iuadivity  ;  and  refembles  pe- 
riodic catarrh  not  only  in  its  fituation  on  a  mucous  membrane, 
but  in  the  difcharge  of  a  thin  fluid.     As  it  is  partly  reftrainable, 
it  does  not  come  under  the  name  of  convulfion  ;  and  as  it  is  not 
attended  with  difficult  refpiration,  it  cannot  be  called  aithma  ; 
it  is  cured  by  very  large  dofes  of  opium,  fee  a  cafe  and  cure  in 
Sea.  XXXVI.  3.  9.  Clafs  IV.  2.  4.  6.  and  feems  immediately 
to  be  induced  by  folar  influence. 

3.  Hyjleria  a  frigore.     Hyfteric  paroxyfms  are  occafioned  by 
whatever  fuddenly  debilitates  the  fyftem,  as  fear,   or  cold,  and 
perhaps  fometimes  by  external  moifture  of  the  air,  as  all  delicate 
people  have  their  days  of  greater  or  lefs  debility,   fee  Clafs  IV. 
3.  1.8. 

4.  Naufea  pluvialis.      Sicknefs  at  the   commencement  of  a 
rainy  feafon  is  very  common  among  dogs,  who  aflift  themfelves 
by  eating    the  agroftis  canina,  or  dog's  grafs,  and  thus  empty 
their  ftomachs.     The  fame  occurs  with  lefs  frequency  to  cats, 
who  make  ufe  of  the  fame  expedient.     See  Seel.  XVI.  n.     I 
have  known  one  perfon,  who  from  his  early  years  has  always 

been 


444 


DISEASES,  &c.        CLASS  IV.  3.  4. 4. 


Tick  at  the  beginning  of  wet  weather,  and  ftill  continues  fo. 
Js  this  owing  to  a  fympathy  of  the  mucous  membrane  of  the  ftom- 
ach  with  the  mechanical  relaxation  of  the  external  cuticle  by  a 
moifter  atmofphere,  as  is  feen  in  the  corrugated  cuticle  of  the 
hands  of  wafher-women  ?  or  does  it  fympathize  with  the  mu- 
cous membrane  of  the  lungs,  which  muft  be  affe&ed  along  with 
the  mucus  on  its  furface  by  the  refpiration  of  a  moifter  atmof- 
phere. 


SUPPLEMENT 


SUPPLEMENT 

TO 

CLASS     IV. 

»  — — •—•^M-  ^ 

Sympathetic  Theory  of  Fever. 

As  fever  confifts  in  the  increafe  or  diminution  of  direft  or 
reverfe  afibciated  motions,  whatever  may  have  been  the  remote 
caufe  of  them,  it  properly  belongs  to  the  fourth  clafs  of  difeaf- 
es  ;  and  is  introduced  at  the  er\d  of  the  clafs,  that  its  great  dif- 
ficulties might  receive  elucidation  from  the  preceding  parts  of 
it.  Thefe  I  fhall  endeavour  to  enumerate  under  the  following 
heads,  trufling  that  the  candid  reader  will  difcover  in  thefe  ru- 
diments of  the  theory  of  fever  a  nafcent  embryon,  an  infant 
Hercules/ which  Time  may  rear  to  maturity,  and  render  fervice- 
able  to  mankind. 

I.  Simple  fever  of  two  kinds. 
II.  Compound  fever. 

III.  Termination  of  the  cold  fit. 

IV.  Return  of  the  cold  fit. 

V.  Seiifation  excited  in  fever. 

VI.  Circles  of  aflbciated  motions. 
VII.  Alternations  of  cold  and  hot  fits. 
VIII.  Orgafm  of  the  capillaries. 

IX.  Torpor  of  the  lungs. 

X.  Torpor  of  the  brain. 

XI.  Torpor  of  the  heart  and  arteries. 
XII.  Torpor  of  the  ftomach  and  inteftines. 

XIII.  Cafe  of  continued  fever  explained. 

XIV.  Termination  of  continued  fever. 
XV.  Inflammation  excited  in  fever. 

XVI.  Recapitulation. 

I.    Simple  Fever. 

i,  When  a  fmall  part  of  the  cutaneous  capillaries  with  their 
mucous  or  perfpirative  glands  are  for  a  fhort  time  expofed  to  a 
colder  medium,  as  when  the  hands  are  immerfed  in  iced  water 

for 


4+6  THEORY  OF  FEVER.          SUP.  I.  i.  i 

, 

for  a  minute,  thcfe  capillary  veflels  and  their  glands  become  tor- 
pid or  quiefcent,  Owing  to  the  eduction  of  the  ftimulus  of  heat. 
The  fkin  then  becomes  pale,  becaufe  no  blood  pafles  through  the 
external  capillaries  ;  and  appears  fhrunk,  becaufe  their  fides  are 
collapfed  from  inactivity,  not  contracted  by  fpafm ;  the  roots 
of  the  hair  are  left  prominent  from  the  feceding  or  fubfiding  of 
the  (kin  around  them  ;  and  the  pain  of  coldnefs  is  produced. 

In  this  fituation,  if  the  ufual  degree  of  warmth  be  applied, 
thefe  veflels  regain  their  activity ;  and  having  now  become 
more  irritable  from  an  accumulation  of  the  fenforial  power  of 
irritation  during  their  quiefcence,  a  greater  exertion  of  them  fol- 
lows, with  an  increafed  glow  of  the  {kin,  and  another  kind  of  pain, 
which  is  called  the  hot-ach  ;  but  no  fever,  properly  fo  called,  is 
yet  produced  ;  as  this  effect  is  not  univerfal,  nor  permanent, 
nor  recurrent. 

2.  If  a  greater  part  of  the, cutaneous  capillaries  with  their 
mucous  and  perfpirative  glands  be  expofed  for  a  longer  time  to 
cold,  the  torpor  or  quiefcence  becomes  extended  by  direct  fym- 
pathy  to  the  heart  and  arteries  ;  which  is  known  by  the  weak- 
nefs,  and  confequent  frequency  of  the  pulfe  in  cold  fits  of  fever. 

This  requires  to  be  further  explained.  The  movements  of 
the  heart  and  arteries,  and  the  whole  of  the  circulatory  veflels, 
are  in  general  excited  into  action  by  the  two  fenforial  powers  of 
irritation,  and  of  aflbciation.  The  former  is  excited  by  ftimu- 
lus, the  latter  by  the  previous  actions  of  a  part  of  the  vital  circle 
of  motions.  In  the  above  fituation  the  capillaries  act  weakly 
from, defect  of  irritation,  which  is  caufed  by  deficient  ftimulus 
of  heat ;  but  the  heart  and  arteries  act  weakly  from  defect  of 
aflbciation,  which  is  owing  to  the  weak  action  of  the  capilla- 
ries j  which  does  not  now  excite  the  fenforial  power  of  aflbcia- 
tion into  action  with  fuflicient  energy. 

After  a  time,  either  by  the  application  of  warmth,  or  by  the 
increafe  of  their  irritability  owing  to  the  accumulation  of  the 
fenforial  power  of  irritation  during  their  previous  quiefcence,  the 
capillary  veflels  and  glands  act  with  greater  energy  than  natural; 
whence'  the  red  colour  and  heat  of  the  fkin.  The  heart  and  ar- 
teries acquire  a  greater  ftrength  of  pulfation,  and  continue  the 
frequency  of  it,  owing  to  the  accumulation  of  the  fenforial  pow- 
er of  aflbciation  during  their  previous  torpor,  and  their  confe- 
quent greater  aflbciability  j  which  is  nowalfo  more  ftrongly  ex- 
cited by  the  increafed  actions  of  the  capillaries.  And  thus  a 
fit  of  fimple  fever  is  produced,  which  is  termed  Febris  irritati- 
va ;  and  confifts  of  a  torpor  of  the  cutaneous  capillaries  with 
their  mucous  and  peripirable  glands,  accompanied  with  a  tor- 

ppr 


SUP.  I.  i.  3.          THEORY  OF  FEVER,  447 

por  of  the  heart  and  arteries ;  and  afterwards  of  an  increafed 
a&ion  of  all  thefe  veflels,  by  what  is  termed  direct  fympathy. 

This  fever,  with  ftrong  pulfe  without  inflammation,  or  febrig 
irritativa,  defcribed  io  Chfsl.  i.  i.,i.  is  frequently  feen  in  ver- 
nal intermittents,  as  the  orgafm  of  the  heart  and  arteries  is  then 
occafioned  by  their  previous  ftate  of  torpor  ;  but  more  rarely  I 
believe  exifts  in  the  type  of  continued  fever,  except  there  be  an 
evident  remiffion,  or  approximation  to  a  cold  fit ;  at  which  time 
a  new  accumulation  of  the  fenforial  power  of  aflbciation  is  pro- 
duced ;  which  afterwards  actuates  the  heart  and  arteries  with 
unnatural  vigour;  or  unlefs  there  be  fome  ftimulus  perpetually 
afting  on  the  fyftem,  fo  as  to  induce  an  increafed  fecretion  of 
fenforial  power  in  the  brain,  as  occurs  in  flight  degrees  of  intoxi- 
cation. Since  without  one  or  other  of  thefe  circumftances  in 
continued  fevers  without  inflammation,  that  is,  without  the  ad- 
ditional fenforial  power  of  fenfation  being  introduced,  it  feems 
difficult  to  account  for  the  production  of  fo  great  a  quantity  of 
fenforial  power,  as  mutt  be  neceflary  to  give  perpetual  increafe 
of  action  to  the  whole  fanguiferous  fyftem. 

3.  On  the  contrary,  while  the  cutaneous  capillaries  with  their 
mucous  and  perfpirative  glands  acquire  an  increafed  irritability, 
as  above,  by  the  accumulation  of  that  fenforial  power  during 
their  previous  quiefcence,  and  thus  conftitute  the  hot  fit  of  fe- 
ver •,  if  the  heart  and  arteries  do  not  acquire  any  increafe  of  af- 
fociability,  but  continue  in  their  ftate  of  torpor,  another  kind  of 
fimple  fever  is  produced  ;  which  is  generally  of  the  continued 
kind,  and  is  termed  Febris  inirritativa  ;  which  confifts  of  a  pre- 
vious torpor  of  the  capillaries  of  the  {kin,  and  of  the  heart  and 
arteries  by  direct  fympathy  with  them  ;  and  afterwards  of  an 
orgafm  or  increafed  a&ion  of  the  capillaries  of  the  {kin,  with  a 
dccreafed  aftion,  or  continued  torpor,  of  the  heart  and  arteries 
by  reverfe  fympathy  with  them.  This  orgafm  of  the  cutaneous 
capillaries,  which  -appears  by  the  blufli  and  heat  of  the  flcin,  is 
at  firft  owing  to  the  accumulation  of  the  fenforial  power  of  irri- 
tation during  their  previous  torpid  ftate,  as  in  the  febris  irritata 
above  defcribed  ;  but  which  is  afterwards  fupported  or  continu- 
ed by  the  reverfe  fympathy  of  thefe  capillaries  with  the  torpid 
ftate  of  the  heart  and  arteries,  as  will  be  further  explained  in  ar- 
ticle 8.  of  this  Supplement. 

4.  The  renovated  activity  of  the  capillaries  commences  a~ 
foon  or  iboner  than  that  of  the  heart  and  arteries  after  the  cold 
fit  of  irritative  fever ;  and  is  not  owing  to  their  being  forced 
open  by  the  blood  being  impelled  into  them  mechanically,  by 
the  renovated  action  of  the  heart  and  arteries ;  for  thefe  capil- 
laries of  the  Ikin  have  greater  mobility  than  the  heart  and  arte- 
ries, 


THEORY  OF  FEVER.          SUP.  I.  i.  $* 

ries,  as  appears  in  the  fudden  blufli  of  fliarne ;  which  may  be 
owing  to  their  being  more  liable  to  perpetual  varieties  of  a&ivi- 
ty  from  their  expofure  ft)  the  viciffitudes  of  atmofpheric  heat. 
And  becaufe  in  inirritative  fevers,  or  thofe  with  arterial  debility, 
the  capillaries  acquire  increafed  ftrength,  as  is  evinced  by  the 
heat  of  the  fkin,  while  the  pulfations  of  the  heart  and  arteries 
remain  feeble. 

5.  It  was  faid  above,  that  the  cutaneous  capillaries,  when 
they  were  rendered  torpid  by  expofure  to  cold,  either  recover- 
ed their  activity  by  the  reapplication  of  external  warmth  ;  or 
by  their  increafed  irritability,  which  is  caufed  by  the  accumu- 
lation  of  that  fenforial  power  during  their  quiefcence.     An 
example  of  the  former  of  tnefe  may  be  feen  on  emerging  from 
a  very  cold  bath  ;  which  produces  a  fit  of  fimple  fever ;  the  cold 
fit,  and  confequent  hot  fit,  of  which  may  be  prolonged  by  con- 
tinuing in  the  bath  j  which  has  indeed  proved  fatal  to  fome  weak 
and  delicate  people,  and  to  others  after  having  been  much  ex- 
haufted  by  heat  and  exercife.     See  Sed~t.  XXXII.   3.   2.     An 
example  of  the  latter  may  be  taken  from  going  into  a   bath  of 
about  eighty  degrees  of  heat,  as  into  the  bath  at  Buxton,  where 
the  bather  firft  feels  a  chill,  and  after  a  minute  becomes  warm, 
though  he  remains  in  the  fame  medium,  owing  to  the  increafe 
of  irritability  from  the  accumulation  of  that  fenforial  power 
during  the  Thort  time  which  the  chilnefs  continued. 

6.  Hence  fimple  fevers  are  of  two  kinds  ;  firfl:,  the  febris  ir- 
ritativa,  or  fever  with  ftrong  pulfe  ;  which  confifts  of  a  previous 
torpor  of  the  heart,   arteries,  and  capillaries,  and  a    fucceeding 
orgafm  of  thofe  veflels.     Secondly,  the  febris  jnirritativa,  or  fe- 
ver with  weak  pulfe,  which  confifts  of  a  previous  torpor  of  the 
heart,  arteries,  and  capillaries ;  and  of  a  fucceeding  orgafm  of 
the  capillaries,  the  torpor  of  the  heart  and  arteries  continuing. 
But  as  the  frequency  of  the  pulfe  occurs  both  in  the  ftate  of  tor- 
por, and  in  that  of  orgafm,  of  the  heart  and  arteries  ;  this  con- 
ilitutes  a  criterion  to  diftinguim  fever  from  other  difeafes,  which 
are  owing  to  the  torpor  of  fome  parts  of  the  fyftem,  as  parefis, 
and  hemicrania. 

7.  The  reader  will  pleafe  to  obferve,  that  where  the  cutane- 
ous or  pulmonary  capillaries  are  mentioned,  their   mucous  and 
perfpirative  glands  are  to   be  imderftood  as  included ;  but   that 
the  abforbents  belonging  to  thofe  fyftems  of  velTels,   and  the 
commencement  of  the  veins,  are  not  always  included  ;   as  thefe 
are  liable  to  torpor  feparately,  as  in  anafarca,  and  petechiae  ;  or 
to  orgafm,  or  increafed  action,  as  in  the  exhibition  of  ftrong 
emetics,  or  in  the  application  of  vinegar  to  the  lips  ;  yet  he  will 
alfo  pU-afe   to  obferve,  that  an  increased  or  decreafed  action,  of 

thefe 


SUP.  I.  a.  i.          THEORY  OF  FEVER.  449 

thefe  abforbents  and  veins  generally  occurs  along  with  that  of 
the  capillaries,  as  appears  by  the  dry  (kin  in  hot  fits  of  fever  ; 
and  from  there  being  generally  at  the  lame  time  no  accumula- 
tion of  venous  blood  in  the  cutaneous  vefTels,  which  would  ap- 
pear by  its  purple  colour. 

II.   Compound  Fever. 

1.  When  other  parts  of  the  fyftem  fympathize  with  this  tor- 
por and  orgafm  of  the  cutaneous  capillaries,   and  of  the  heart 
and  arteries ;  the  fever-fit  becomes  more  complicated  and  dan- 
gerous ;  and  this  in  proportion  to  the  number  and   confequence 
of  fuch  affected  parts.     Thus  if  the  lungs  become  affected,  as 
in  going  into  very  cold  water,  a    fhortnefs   of  breath   occurs ; 
which  is  owing  to  the  collapfe  or  inactivity  (not  to   the  active 
contraction,  or  fpafm),  of  the  pulmonary  capillaries  ;  which,  as 
the   lungs   are   not  fenfible  to  cold,  are  not   fubject  to  painful 
fenfation,  and  confequent  fhuddering,  like  the  (kin.     In  this  cafe 
after  a  time  the  pulmonary  capillaries,  like  the  cutaneous  ones, 
act   with  increafed  energy  ;  the  breathing,  which  was  before 
quick,  and  the  air  thrown  out  at  each  refpiration  in  lefs  quanti- 
ty, and  cool  to  the  back  of  the  hand  oppofed  to  it,  now  becomes 
larger  in  quantity,  and  warmer  than  natural ;  which  however  is 
not  accompanied  with  the  fenfation  of  heat  in  the  membrane, 
which   lines  the  air-yeflels  of  the  lungs,  as  in  the  Ikin. 

2.  One  confequence  of  this  increafed  heat  of  the  breath  is 
the  increafed  evaporation  of  the  mucus  on  the  tongue  and  nof- 
trils.     A  vifcid  materal  is  fecreted  by  thefe  membrane^  to  pre- 
ferve  them  moift  and  fupple,  for  the  purpofes  of  the  fenfes  of 
tafte  and  of  fmcll,  which  are  extended  beneath  their  furfaces  ; 
this  vifcid  mucus,  when  the  aqueous  part  of  it  is  evaporated  by 
the  increafed  heat  of  the  refpired  air,  or  is  abforbed  by  the  too 
great  action  of  the  mucous  abforbents,  adheres  clofely  on  thofe 
membranes,  and  is  not  without  difficulty  to  be   feparated  from 
them.     This  drynefs  of  the  tongue  and  noftrils  is  a  circumilance 
therefore  worthy  to  be  attended  to  ;   as  it  (hews   the  increafed 
action  of  the  pulmonary  capillaries,  and  the  confequent  increaf- 
ed heat  of  the  expired  air ;  and  may  thus  indicate,  when  colder 
air  fhould  be  admitted  to  the   patient:.     See   Clais  I.    i.  3.    i. 
The  middle  part  of  the  tongue  becomes  dry  fooner,  and  recov- 
ers its  moifture  later,  than  the  edges  of  it ;  becaufe  the  currents 
of  refpired  air  pals  moft  over  the  middle  part  of  it.     This  how- 
ever is  not  the  cafe,   when  the  dryne's  of  the  tongue  is  owing 
only    to   the  increafed   mucous  abforption.     When  however  a 
frequent  cough  attends  pulmonary  inflammation,  the  edges  of 

VOL,  II.  K  K  k  '    the 


45  °  THEORY  OF  FEVER.          SUP.  I.  2.  3. 

the  tongue  are  liable  to  be  as  much  furred  as  the  middle  of  it  ; 
as  during  the  action  of  coughing  the  middle  of  the  tongue  is  de- 
prefled,  ib  as  to  form  half  a  cylinder,  to  give  a  greater  aperture 
for  the  emiffion  of  air  from  the  larynx  ;  and  the  edges  of  it  be- 
come thus  as  much  expofed  to  the  currents  of  air  as  the  middle 
parts  of  it. 

3 .  When  the  internal  capillaries  or  glands  fympathize  with 
the  cutaneous  capillaries  ;  or  when  any  of  them  are  previoufly 
affected  with   torpor,  and  the  external  or  cutaneous  capillaries 
are  affe&ed  fecondarily;  other  fymptoms  are  produced,  which  ren- 
der the  paroxyfms  of  fever  itill  more  complicate.     Thus  if  the 
fpleen  or  pancreas  are  primarily  or  fecondarily  affected,  fo  as  to 
be  rendered  torpid  or  quiefcent,  they  are  liable  to  become  en- 
larged, and  to  remain  fo  even  after  the  extinction  of  the  fever- 
fit.     Thefe  in  fome  intermittent  fevers  are  perceptible  to  the 
hand,  and  are  called  ague-cakes  j  their  tumour  feems  to  be  ow- 
ing to  the  permanent  torpor  of  the  abforbent  fyftem,  the  fecern- 
ing  veflels  continuing  to  act  fome  time  afterwards.     If  the  fe- 
cretory  veflels  of  the  liver  are  affected  firft  with  torpor,  and  af- 
terwards with  orgafm,  a  greater  fecretion  of  bile  is  produced, 
which  fometimes  caufes  a  diarrhoea.    If  a  torpor  of  the  kidneys, 
and  of  the  abforbents  of  the  bladder  occurs,  either  primarily,  or 
by  fympathy  with  the  cutaneous  capillaries,  the  urine  is  in  fmall 
quantity  and  pale,  as  explained  in  Clafs  I.  2.  2.  5. 5  and  if  thefe 
fecretory  veflels  of  the  kidneys,  and  the  abforbents  of  the  bladder 
act  more  ftrongly  than  natural  afterwards  by  their  increafed  irri- 
tability or  afibciability,  the  urine  becomes  in  larger  quantity,  and 
deeper  coloured,  or  depofits  its  earthy  parts,  as  in  Clafs  I.  1.2. 
4.  which  has  been  efleemed  a  favourable  circumftaoce.     But  if 
the  urine  be  in  fmall  quantity,  and  no  fediment  appears  in  it,  af- 
ter the  hot  fit  is  over  ;  it  (hews  that  the  fecerning  veflels  of  the 
kidneys  and  the  abforbent  veflels  of  the  bladder  have  not  regain- 
ed the  whole  of  their  activity,  and  thence  indicates  a  greater 
tendency  to  a  return  of  the  cold  fit. 

4.  When  the  (tomach  is  affected  with  torpor  either  primari- 
ly ;  or  fecondarily  by  its  fympathy  with  the  cutaneous  capilla- 
ries 5  or  with  fome  internal  vifcus  ;  ficknefs  occurs,  with  a  total 
want  of  appetite  to  any  thing  folid  ;  vomiting  then  fupervenes> 
which  may  often  be  relieved  by  a  blifter  on  the  (kin,  if  the  fkin 
be  cool  and  pale  •,  but  not  if  it  be  hot  and  flufhed.     The  intef- 
tines  ceafe  to  perform  their  office  of  abforption  from  a  fimilar 
torpor  ;  and  a  diarrhoea  fupervenes  owing  to  the  acrimony  of 
rheir  putrid,  or  of  their  acid  contents.     The  loofe  undigested  or 
fetid  itools  indicate  the  inability  of  the  inteftines  to  perform 
their  proper  office  ;  as  the  mucus  and  gaftric  acid,  which  are 

vomited 


SUP.  I.  2.  5.          THEORY  OF  FEVER.  45  * 

vomited  up,  docs  that  of  the  ftomach ;  this  torpor  of  the  ftom- 
ach  is  liable  to  continue  after  the  cold  paroxyfm  ceafes,  and  to 
convert  intermittent  fevers  into  continued  ones  by  its  dire£t 
fympathy  with  the  heart  and  arteries.  See  article  10.  of  this 
Supplement. 

5.  If  the  meninges  of  the  brain  fympathize  with  ocher  torpid 
parts,  or  are  primarily  affefted,  delirium,  ftupor,  and  perhaps 
hydrocephalus  internus,  occur,  fee  Clafs  II.  1.7.  i.  and  I.  2.  5. 
ID  ;  and  fometimes  the  pulfe  becomes  flow,  producing  parefis 
inftead  of  fever.     But  if  the  membranes,  which  cover  the  muf- 
cles  about  the  head,  or  of  the  pericranium,  become  torpid  by 
their  fympathy  with  other  torpid  parts,  or  are  primarily  affecl:- 
ed,  a  head-ach  fupervenes  ;  which  however  generally  ceafes 
with  the   cold  paroxyfm  of  fever.     For  as  when  the  ienforial 
power  of  volition  is  exhaufted  by  labour,  a  few  hours,  or  half  a 
folar  day,  patted  in  fleep  recruits  the  fyftem  by  accumulation  of 
this  fenforial  power  ;  fo  when  the  fenforial  power  of  irritation  is 
exhaufted,  one  or  two  folar  or  lunar  days  of  reft  or  quiefcence 
of  the  affected  part  will  generally  reftore  its  action  by  accumu- 
lation of  irritability,  and  confequent  increafe  of  aflbciation,  as  in 
hemicraniaj  Clafs  IV.  2.  2.  8.     But  when  the  heart  and  arteries 
become  torpid,  either  primarily,  or  by  their  fympathy  with  the 
ftomach,  this  accumulation  of  the  fenforial  power  of  irritation 
can  take  place  but  flowly  ;  as  to  reft  is  death  /  This  explains  the 
caufe  of  the  duration  of  fevers  with  weak  pulfe,  which  con- 
tinue a  quarter,  or  half,  or  three  quarters,  or  a  whole  lunation, 
or  {till  longer,  before  fufficient  accumulation  of  irritability  can 
be  produced  to  reftore  their  natural  ftrength  of  aclion. 

6.  If  the  abforbent  veflels,  which  are  fpread  around  the  neck 
of  the  bladder,  become  torpid  by  their  difedfc  fympathy  with  the 
abforbents  of  the  fldn  in  cold  fits  of  fever ;  the  urine,  which  is 
poured  into  the  bladder  in  but  fmall  quantity  from  the  torpid 
kidneys,  has  neverthelefs  none  of  its  aqueous  faline  part  reab- 
forbed  j  and  this  faline  part  itimulates  the  bladder  to  empty  it- 
felf  frequently,  though  the  urine  is  in  fmall  quantity.     Which 
is  not  therefore  owing  to  any  fuppofed  fpafm  of  the  bladder,  for 
the  action  of  it  in  excluding  the  urine  is  weak,  and  as  much  con- 
trollable by  the  will  as  in  ordinary  micturition. 

7.  If  the  beginnings  or  abforbent  mouths  of  the  venous  fyf- 
tem remain  torpid,  petechice  or  vibices  are  produced  in  fevers, 
fimilar  to  thofe  which  are  feen  in  fcurvy  without  fever.     If  the 
ikin  was  frequently  moiitened  for  an  hour,  and  at  the  fame 
time  expofed  to  the  common  air,  or  to  oxygen  gas,  it  might  con- 
tribute to  turn  the  black  colour  of  theie'  points  of  extravafated 
blood  into  icavlet,  and  thus  by  increaiing  its  ftimulus  facilitate 

its 


452  THEORY  OF  FEVER.          SUP.  I.  2.  8. 

its  reabforption  ?  For  oxygen  gas  penetrates  moift  animal  mem- 
branes though  not  df  y  ones,  as  in  the  lungs  during  refpiration. 
See  Clafs  I.  2.  i.  17. 

8.  When  the  fenforial  ppwer  of  fenfation  is  introduced  into 
the  arteriaj  fyflem,  other  kinds  of  compound  fevers  are  produc- 
ed, which  will  be  fpoken  of  in  their  place. 

III.  Termination  of  the  cold  pit. 

1 .  If  all  the  parts,  which  were  affe&ed  with  torpor,  regain 
their  irritability,  ard  ailoc  lability,  the  cold  paroxyfm  of  fever 
ceafes i  but  as  fome  or  the  parts  affe  -ted  were  previouily  accuf- 
tomed  to  inceffant  action,  as  the  heart  and  arteries,  and  others 
only  to  intermitted  action,  as  the  ftomach  and  inteftines  ;  and 
as  thofe,  which  are  fubj^ctsd  during  health  to  perpetual  action, 
accumulate  ienforial  pt-wer  falter,  when  their  motions  are  im- 
peded, than  thole  which  are  iubje&ed  to  intermitted  adrion  -,  it 
happens,  that  fome  of  the  parts,  which  were  affected  with  tor- 
por caring  the  coid  fit,  recover  their  irritability  or  aflbciability 
iboner  than  others,  and  more  perfectly,  or  acquire  a  greater 
quantity  of  them  than  natural ;  as  appears  by  the  partial  heat 
and  fiumings  previous  to  the  6e,ieral  hot  fit. 

Hence  if  all  the  parts,  whioh  were  previouily  torpid,  regain 
their  due  degree  of  irritability,  or  of  aflbciability,  the  difeafe  is 
removed,  arid  health  reftored.  If  fome  or  all  of  them  acquire 
more  than  their  natural  degree  of  thefe  fenforial  powers  ;  in- 
creafed- actions,  and  confequent  increafed  fecretions,  and  greater 
heat  occur,  and  conftitute  the  hoc  fit  of  fever.  If  after  this  hot 
fit  of  fever  all  the  parts,  which  had  acquired  too  great  irritabili- 
ty, or  affectability,  regain  their  natural  degree  of  it  •,  the  dif- 
eafe is  removed,  and  health  reftored.  But  if  fome  of  thefe  parts 
do  not  regain  their  natural  degree  of  thefe  fenforial  powers,  the 
actions  of  thofe  p^rts  remain  imperfecl:,  and  are  more  or  lefs 
injurious  to  the  fyftem,  according  to  the  importance  of  their 
functions. 

2.  Thus  if  a  torpor  of  the  heart  and  arteries  remains  ;  the 
quick  pulfe  without  ftrength,  which  began  in  the  cold  fit,  per- 
iifts  j  and  a  continued  fever  is  produced.     If  the  torpor  of  the 
ftomach  and  inteftines  remains,  which  is  known  by  ficknefs  and 
un-iigefted  itools,  the  fever  is  liable  to  be  of  confiderable  length 
and  danger  ;  the  fame  if  the  kidneys  and  abforbent  fyftem  re- 
tain fome  degree  of  torpor,  as  is  (hewn  by  the  pale  urine  in  not 
unufual  quantity.     If  part  of  the  abforbent  fyftem  remains  tor- 
pid, as  the  abfcibent  vefTels  of  the  fpleen,  a  tumour  of  that  vif- 
cus  occurs,  which  may  be  felt  by  the  hand  ;  the  fame  fome- 

times 


SUP.  I.  3. 3  THEORY  OF  FEVER.  453 

times  happens  to  the  liver ;  and  thefe  from  their  tendency  to 
more  complete  torpor  are  afterwards  liable  to  give  occafion  to  a 
return  of  the  cold  fit.  If  the  cellular  abforbents  do  not  com- 
pletely recover  their  activity,  a  pale  and  bloated  countenance 
with  (welled  legs  marks  their  want  of  action. 

3.  As  the  termination  of  the  cold  fit  is  owing  to  the  accumu- 
lation of  the  fenforial  power  of  irritation  and  of  aflbciation  du- 
ring the  previous  quiefcence  of  the  fyftem  ;  and  as  thofe  parts, 
which  are  in  perpetual  action  during  health,  are  more  fubjecl: 
to  this  accumulation  during  their  torpor,  or  quiefcence ;  one 
fhould  have  imagined,  that  the  heart  and  arteries  would  acquire 
this  accumulation  of  fenforial  power  fooner  or  in  greater  degree 
than  other  parts.  This  indeed  fo  happens,  where  the  pulfe  is 
previoufly  ftrong,  as  in  febris  irritativa ;  cr  where  another  fen- 
forial power,  as  that  of  fenfation,  is  exerted  on  the  arterial  fyf- 
tem, as  in  inflammations.  The  heart  and  arteries  in  thefe  cafes 
foon  recover  from  their  torpor,  and  are  exerted  with  great  vi- 
olence. 

Many  other  parts  of  the  fyftem  fubjecl:  to  perpetual  motion 
in  health  may  reft  for  a  time  without  much  inconvenience 
to  the  whole  ;  as  when  the  fingers  of  fome  people  become  cold 
and  pale  ;  and  during  this  complete  reft  great  accumulation  of 
irritability  may  be  produced.  But  where  the  heart  and  ar- 
teries are  previoufly  feeble,  they  cannot  much  diminifii  their 
actions,  and  certainly  cannot  reft  entirely,  for  that  would  be 
death  ;  and  therefore  in  this  cafe  their  accumulation  of  the  fen- 
forial power  of  irritation  or  of  aflbciation  is  ilowly  produced, 
and  a  long  fever  fupervenes  in  confcquence  ;  or  fudden  death, 
as  frequendy  happens,  terminates  the  cold  fit. 

Whence  it  appears,  that  in  fevers  with  weak  pulfe,  if  the  ac- 
tion of  the  heart,  arteries,  and  capillaries  could  be  diminimed, 
or  flopped  for  a  fhort  time  without  occalioning  the  death  of  the 
patient,  as  happens  in  cold  bathing,  or  to  perfons  apparently 
drowned,  that  a  great  accumulation  of  the  fenforial  powers  of 
irritation  or  of  aflbciation  might  foon  be  produced,  and  the  pulfe 
become  ftronger,  and  confequently  flower,  and  the  fever  ceafe. 
Hence  cold  ablution  may  be  of  fervice  in  fevers  "with  weak 
pulfe,  by  preventing  the  expenditure  and  producing  accumula- 
tion of  the  fenforial  power  of  irritation  or  aflbciation.  Stupor 
may  be  ufeful  on  the  fame  account.  Could  a  centrifugal  fwing 
be  ferviceable  for  this  purpofe,  either  by  placing  the  head  or  the 
feet  in  the  outward  part  of  the  circle,  as  defcribed  in  Art.  15.  7. 
pf  this  Supplement  ? 

IV. 


454  THEORY  OF  FEVER.  SUP  I. 


IV.  Return  of  the  cold  Fit. 

1.  If  the   increafed  aclion  of  the  cutaneous  and  pulmom 
capillaries,  and  of  the  heart  and  arteries,  in  febris  irritativa,  con- 
tinues long  and  with  violence,  a  proportional  expenditure  or  ex- 
hauftion  of  fenforial  power  occurs  ;  which  by  its  tendency  to  in- 
duce torpor  of  fome  part,  or  of  the  whole,  brings  on  a  return  of 
the  cold  fit. 

2.  Another  caufe  which  contributes  to  iriduce  torpor  of  the 
whole  fyftem  by  the  fympathy  of  its  parts  with  each  other,  is 
the  remaining  torpor  of  fome  vifcus  ;  which  after  the  laft  cold 
paroxyfm  had  not  recovered  itfelf,  as  of  the  fpleen,  liver,  kid- 
neys, or  of  the  ftomach  and  inteftines,  or  abforbent  veflels,  as 
above  mentioned. 

3.  Other  caufes  are  the  deficiency  of  the  natural  ftimuli, 
hunger,  thirft,  and  want  of  frefh  air.     Other  caufes  are  grej 
fatigue,  want  of  reft,  fear,  grief,  or  anxiety  of  mind.   And  laftly, 
the  influence  of  external  ethereal  fluids,  as  the  defect  of  exter- 
nal heat,  and  of  folar  or  lunar  gravitation.     Of  the  latter  the 
return  of  the  paroxyfms  of  continued  fevers  about  fix  o'clock  in 
the  evening,  when  the  folar  gravitation  is  the  leaft,  affords  an 
example  of  the  influence  of  it ;  and  the  ufual  periods  of  inter- 
mittents,  whether  quotidian,  tertian,  or  quartan,  which  fo  regu- 
larly obey  folar  or  lunar  days,  afford  inftances  of  the  influence  of 
thofe  luminaries  on  thefe  kinds  of  fevers. 

4.  If  the  tendency  to  torpor  of  fome  vifcus  is  confiderable, 
this  will  be  increafed  at  the  time,  when  the  terrene  gravitation 
is  greateft,  as  explained  in  the  introduction  to  Clafs  IV.   2.  4. 
and  may  either  produce  a  cold  paroxyfm  of  quotidian  fever  ;   or 
it  may  not  yet  be  fufficient  in  quantity  for  that  purpofe,  but  may 
neverthelefs  become  greater,  and  continue  fo  till  the  next  period 
of  the  greateft  terrene  gravitation,  and  may  then  either  produce 
a  paroxyfm  of  tertian  fever  ;  or  may  ftill  become  greater,  and 
continue  fo  till  the  next  period  of  greateft  terrene  gravitation,  and 
then  produce  a  paroxyfm  of  quartan  ague.     And  laftly,  the  pe- 
riodical times  of  thefe  paroxyfms  may  exceed,  or  fall  fhort  of, 
the  time  of  greateft  diurnal  terrene  gravitation  according  to  the 
time  of  day,  or  period  of  the  moon,  in  which  the  firft  fit  began  ; 
tint  is,  whether  the  diurnal  terrene  gravitation  was  then  in  an 
increafmg  or  decreafmg  ftate. 

V.   Senfation  excited  in  Fever. 

i.  A  curious  obfenration  is  related  by  Dr.  Fordvc*  in   his 

Trad 


SUP.  1. 5. 2.  THEORY  OF  FEVER.  455 

Tra£fc  on  Simple  fever,  page  168.  He  aflerts,  that  thofe  people* 
who  have  been  confined  fome  time  in  a  very  warm  atmofphere, 
as  of  120  or  130  degrees  of  heat,. do  not  feel  cold,  nor  are  fub- 
jeft  to  palenefs  of  their  fkins,  on  coming  into  a  temperature  of 
30  or  40  degrees  ;  which  would  produce  great  palenefs  and 
painful  fenfation  of  coldnefs  in  thole,  who  had  been  fome  time 
confined  in  an  atmofphere  of  only  86  or  90  degrees.  Analo- 
gous to  this,  an  obferving  friend  of  mine  allured  me,  that  once 
having  fat  up  to  a  very  late  hour  with  three  or  four  very  inge- 
nious and  humorous  companions,  and  drunk  a  confiderable 
quantity  of  wine  ;  both  contrary  to  his  ufual  habits  of  life  ;  and 
being  obliged  to  rife  early,  and  to  ride  a  long  journey  on  the 
next  day  ;  he  expected  to  have  found  himfelf  weak  and  fopn 
fatigued ;  but  on  the  contrary  he  performed  his  journey  with 
unufual  eafe  and  alacrity  ;  and  frequently  laughed,  as  he  rode, 
at  the  wit  of  the  preceding  evening.  In  both  thefe  cafes  a  de- 
gree of  pain  or  pleafure  actuated  the  fyftem  •,  and  thus  a  fenfo- 
rial  power,  that  of  fenfation,  was  fuperadded  to  that  of  irrita- 
tion, or  volition.  See  Seel.  XXXIV.  ^.  6. 

2.  Similar  to  this,  when  the  energetic  exertions  of  fome  parts 
of  the  fyftem  in  the  hot  fit  of  fever  arife  to  a  certain  excefs,  a 
degree  of  fenfation   is  produced  ;  as  of  heat  which  particularly 
increafes  the  actions  of  the  cutaneous  velTels,  which  are  more 
liable  to  be  excited  by  this  ftimulus.     When  this  additional  fen- 
forial   power  of  fenfation  exifts  to  a  greater  degree,  the  pulfe, 
which  was  before  full,  now  becomes  hard,  owing  to  the  inflam- 
mation of  the  vafa  vaforum,  or  coats  of  the  arteries.  In  thefe  cafes 
whether  there  is  any  topical  inflammation  or  not,  the  fever  ceaf- 
es  to  intermit ;  but  neverthelefs   there  are  daily  remiflions  and 
exacerbations  of  it ;  which  recur  for  the  moft  part  about  fix  in 
the  evening,  when  the  folar  gravitation  is  the  leait,  as  mention- 
ed in  Sea.  XXXVI.  3.  7. 

3.  Thus  the  introduction  of  another  fenforial  power,  that  of 
fenfation,  converts  an  intermittent  fever  into  a  continued  one. 
If  it  be  attended  with  ftrong^  pulfe,  it  is  termedjfebris  fenfuiva  ir- 
litata,  or  pyrexia,  or  inflammation  ;  if  with  a  weak  pulie,  is  is 
termed  febris  fenfitiva  inirritata,  or  typhus  gravior,  or  malignant 
fever.    The  feat  of  the  inflammation  is  in  the  glandular  or  capil- 
lary fyftem,  as  it  confifts  in  the  fecretion  of  new  fluids,  or  new 
fibres,  which  form  new  vclTels,  as  they  harden,  like  the   iilk  of 
the  filk-worm.     See  Art.  15.  of  this  Supplement. 

VI.   Circles  of  irritative  Ajficiaic 
J.  There  are  fome   aflbciate  motions,  \vht~h  are  perjlKualiy 


456  THEORY  OF  FEVER,  SUP.  1. 6. 

proceeding  in  our  waking  hours,  and  are  catenated  by  their  firft 
link,  or  in  fome  fubfequent  parts  of  the  chain,  with  the  ftimuii 
or  the  influence  of  external  things ;  which  we  (hall  here  enu- 
merate, as  they  contribute  to  the  knowledge  of  fever.  Of  thefe 
are  the  irritative  ideas,  or  fenfual  motions  of  the  organs  of  fenfe, 
and  the  mufcular  motions  aflbciated  with  them  \  which,  when 
the  chain  is  difturbed  or  interrupted,  excite  the  fenforial  power 
of  fenfation,  and  proceed  in  confufion.  Thus  if  the  irritative 
ideas  of  fight  are  difturbed,  the  paralaftic  motions  of  objects, 
which  in  general  are  unperceived,  becomes  fenfible  to  us ;  and 
the  locomotive  mufcles  aflbciated  with  them,  which  ought  to 
preferve  the  body  erect,  dagger  from  this  decreafe  or  interrup- 
tion of  the  fenforial  power  of  afToeiation  ;  and  vertigo  is  pro- 
duced. 

When  the  irritative  fenfual  motions,  or  ideas,  belonging  to 
One  fenfe  are  ihcreafed  or  diminiihed,  the  irritative  fenfual  mo- 
tioxis,  or  ideas,  of  the  other  fenfes  are  liable  to  become  difturbed 
by  their  general  catenations ;  whence  occur  noifes  in  the  ears, 
bad  taftes  in  the  mouth,  bad  odours,  and  numbnefs  or  tingling 
of  the  limbs,  as  a  greater  or  lefs  number  of  fenfes  are  affected. 
Thefe  conftitute  concomitant  circles  of  difturbed  irritative  ideas ; 
or  make  a  part  of  the  great  circle  of  irritative  ideas,  or  motions 
of  the  organs  of  fenfe  ;  and  when* thus  difturbed  occafion  many 
kinds  of  hallucination  of  our  other  fenfes,  or  attend  on  the  ver- 
tigo of  vifion. 

2.  Another  great  circle   of  irritative  aflbciated  motions  con- 
fifts  of  thofe  of  the  alimentary  canal ;  which  are  catenated  with 
ftimuii  or  with  influences  external   to  the  fyftem,  but  continue 
to  be  exerted  in  our  fleeping    as  well    as  in  our  waking  hours. 
When  thefe  aflbciations  of  motion  are  difturbed  by  the  too  great 
or  too  fmall  ftimulus  of  the  food  taken  into  the  ftomach,  or  by 
the  too  great  excefs  or  deprivation   of  heat,  or  by  indigestible 
fubftances,  or  by   torpor  or  orgafm  occaGoned  by  their  aflbcia- 
tion  with  other   parts,  various  difeafes  are  induced  under  the 
names  of  apepfia,  hypochondriafis/  hyfteria,  diarrhoea,  cholera, 
ileus,  nephritis,  fever. 

3.  A  third  circle  of  irritative  aflbciate  motions  confifts  of  thofe 
of  the  abforbent  fyftem ;  which  may   be  divided  into  two,  the 
latteals,  and  the  lymphatics.     When  the  ftomach  and  inteftines 
are  recently  filled  with  food  and  fluid,   the  lacteal  fyftem  is 
ftimnhted  into  great  action  ;  at  the  fame  time  the  cellular,  cuta- 
neous, and  pulmonary  lymphatics  act  with  lefs  energy;  becaufe 
Icfs  fluid  is  then  wanted  from  thofe  branches,  and  becauie  more 
fenforial  power  is  expended  by  the  lacteal  branch.     On  this  ac- 

;  thefe  tvv-o  fyflemR   of  abforbents  are  liable  to  act  by  re- 

verfe 


SUP.  1. *. 4.  THEORY  OF  FEVER,  457 

verfe  fympatfiy  ;  hence  pale  urine  is  made  after  a  full  dinner,  as 
lefs  of  the  aqueous  part  of  it  is  imbibed  by  the  urinary  lym- 
phatics ;  and  hence  the  water  in  anafarca  of  the  lungs  and  limbs 
is  fpeedily  abforbed,  when  the  actions  of  the  lafteals  of  the 
ftonvach  or  inteftiues  are  weakened  or  inverted  by  the  exhibition 
of  thofe  drugs,  which  produce  naufea,  or  by  violent  vomiting, 
or  violent  cathartics. 

Hence  in  diabetes  the  lafteal  fyftem  a£h  ftrongly,  at  the  fame 
time  that  the  urinary  lymphatics  invert  their  motions,  and  tranf- 
mit  the  chyle  into  the  bladder  -,  and  in  diarrhcea  from  crapula, 
or  too  great  a  quantity  of  food  and  fluid  taken  at  a  time> 
the  lacleals  ad  ftrongly,  and  ab'brb  chyle  or  fluids  from  the 
ftomach  and  upper  iiueftines  -,  while  the  lymphatics  of  the  low- 
er interlines  revert  their  motions,  and  tranfmit  this  over-repletion 
into  the  lower  interlines,  and  thus  produce  diarrhoea  ;  which 
accounts  for  the  fpeedy  operation  of  fome  cathartic  drugs,  when 
much  fluid  is  taken  along  with  them. 

4.  Other  circles  of  irritative  aflbciate  motions  of  great  impor- 
tance are  thofe  of  the  fecreting  fyftem  ;  of  thefe  are  the  motions 
of  the  larger  congeries  of  glands,  which  form  the  liver,  fpleen, 
pancreas,  gaftric  glands,  kidneys,  falivary  glands,  and  many  oth- 
ers ;  fome  of  which  aft  by  direcl:  and  others  by  reverfe  fympa- 
thy  with  each  other.  Thus  when  the  gaftric  glands  ac~l  moft 
powerfully,  as  when  the  ftomach  is  filled  with  food,  the  kidneys 
act  with  lefs  energy  ;  as  is  fhewn  by  the  fmall  fecretion  of 
urine  for  the  firft  hour  or  two  after  dinner ;  which  reverfe  fym- 
pathy  is  occafioned  by  the  greater  expenditure  of  fenforial  pow- 
er on  the  gaftric  glands,  and  to  the  newly  abforbed  fluids  not 
yet  being  fufficiently  animalized,  or  otherwife  prepared;  to  ftim- 
ulate  the  fecretory  vefTels  of  the  kidneys. 

But  thofe  very  extenfive  glands,  which  fecrete  the  perfpira- 
ble  matter  of  the  (kin  and  lungs,  with  the  mucus,  which  lubri- 
cates all  the  internal  cells  and  cavities  of  the  body,  claim  our 
particular  attention.  Thefe  glands,  as  well  as  all  the  others> 
proceed  from  the  capillary  vdffeta  which  unite  the  arteries  with 
the  veins,  and  are  not  properly  a  part  of  them  j  the  mucous  and 
pertpirative  glands,  which  anfe  irom  the  cutaneous  and  pulmo- 
nary capillaries,  are  aflbciated  by  direcl:  fympathy  ;  as  appears 
from  immerfion  in  the  cold  bath,  which  is  therefore  attended 
with  a  temporary  difficult  ref  ^intion  ;  while  thole  from  the  ca- 
pillaries of  the  ftomach  and  heart  and  arteries  are  more  gener- 
ally atTociated  by  reverfe  fympathy  with  thofe  of  the  cutaneous 
capillaries  ;  as  appears  in  fevers  with  weak  pulfe  and  indigeftion, 
and  at  the  famevtime  with  hot  and  dry  {kin. 

The  diilurbe3  aftions  of  this  circle  of  the  aflbciate  motions  of 

VOL.  II.  L  L  1  the 


45  3  THEORY  OF  FEVER.  SUP.  1. 6. 


,. 


the  fecerning  fyftem,  when  the  fenforial  power  of  fenfation  is 
added  to  that  of  irirtation,  frequently  produces  inflammation, 
•which  confifts  in  the  fecretion  of  new  fluids  or  new  veflels. 
Neverthelefs,  if  thefe  difturbed  actions  be  of  the  torpid  kind, 
the  pain,  which  attends  them,  is  feldom  productive  of  inflam- 
mation, as  in  hemicrania  ;  but  is  liable  to  excite  voluntary  ac- 
tions, and  thus  to  expend  much  fe^iforial  power,  as  in  the  fhud- 
dering  in  cold  fits  of  fever,  or  in  convulfions  ;  or  laitly  the  pain 
itfelf,  which  attends  torpid  actions,  is  liable  to  expend  or  ex- 
hauft  much  fenforial  power  without  producing  any  increafed 
aclions  ;  whence  the  low  pulfe,  and  cold  extremities,  which  ufu- 
ally  attend  hemicrania  j  and  hence  when  inert,  or  inactive  fen- 
fation attends  one  link  of  aflbciated  action,  the  fncceeding  link 
is  generally  rendered  torpid,  as  a  coldnefs  of  the  cheek  attends 
tooth-ach. 

5.  A  fifth  important  circle  of  irritative  motions  is  that  of  the 
fanguiferous  fyftem,  in  which  the  capillary  veflels  are  to  be  in- 
cluded, which  unite  the   arterial  and  venous  fyftems,  both  pul- 
monary and  aortal.     The  difturbed  adtion  of  this  fyftem  of  the 
heart  and  arteries,  and  capillaries,  conftitutes  fimple    fever ;  to 
which  may  be  added,  that  the  fecerning  and  abibrbent  veflels 
appending  to  the  capillaries,  and  the  bibulous  mouths  of  the 
veins,  are  in  fome  meafure  at  the   fame  time  generally  afFe£ted. 

6.  Now,  though  the  links  of  each  of  thefe  circles  of  irritative 
motions  are  more  ftr  icily  aflbciated  together,  yet  are  they  in 
greater  or  lefs  degree  aflbciated  or  catenated  with  each  other  by 
direct  or  reverfe  fympathy.     Thus  the  ficknefs,  or  inverted  irri- 
tative motions  of  the  ftomach,  are    aflbciated  or  catenated  with 
the  difturbed  irritative  ideas,  or  fenfual  motions,  in  vertigo  ;  as 
in  fea-ficknefs.     This  ficknefs  of  the   ftomach  is  alfo  aflbciated 
or  catenated  with  the  torpor  of  the  heart  and  arteries  by  direct 
fympathy,   and  with  the  capillaries  and  abforbents  by  reverfe 
fympathy  ;  and  are  thus  all  of  them  liable  occafionally  to  be  dif- 
turbed, when  one  of  them  is  difeafed  j  and  couftitute  the  great 
variety  of  the  kinds  or  fymptoms  of  fevers. 


VII.  -Alternation  of  the  cold  and  hot  Fits. 


PY 


i .  When  any  caufe  occurs,  which  diminifhes  to  a  certain  de- 
gree the  fupply  of  fenforial  power  in  refpect  to  the  whole  fyf- 
tem ;  as  fuppofe  a  temporary  inexertion  of  the  brain  ;  what 
happens  ?  Firft,  thofe  motions  are  exerted  with  lefs  energy, 
which  are  not  immediately  neceflary  to  life,  as  the  locomotive 
mufcles ;  and  thofe  ideas,  which  are  generally  excited  by  voli- 
tion, at  the  lame  time  this  deficiency  of  voluntary  motion  is 

different 


SUP.  I.  7. 2.  THEORY  OF  FEVER.  459 

different  from  that  which  occurs  in  fleep  ;  as  in  that  the  move- 
ments of  the  arterial  fyftem  are  increafed  in  energy  though  not 
in  frequency.  Next,  the  motions  of  the  alimentary  canal  be- 
come performed  with  lefs  energy,  or  ceafe  altogether  ;  and  a 
total  want  of  appetite  to  folid  food  occurs,  or  ficknefs  or  a  diar- 
rhoea occafioned  by  the  indigefted  aliment.  Then  the  abforbent 
veflels  ceafe  to  adt  with  their  due  energy ;  whence  thirft,  and 
pale  urine,  though  in  fmall  quantities.  Fourthly,  the  fecerning 
veflels  become  affected  by  the  general  diminution  of  f-nforial 
power ;  whence  all  the  fecreted  fluids  are  produced  in  lefs 
quantity.  And  laftly,  the  fanguiferous  canals  feel  the  general 
torpor  ;  the  pulfations  of  the  heart  and  arteries  become  feeble, 
and  confequently  quick  ;  and  the  capillaries  of  the  (kin  become 
inactive,  acquire  lefs  blood  from  the  arteries,  and  are  confe- 
quently paler  and  flirunk. 

In  this  laft  circumftance  of  the  torpor  of  the  fanguiferous 
fyftem  confifts  inirritative  fever  ;  as  all  the  others  are  rather  ac- 
cidental or  concomitant  fymptoms,  and  not  eflential  ones ;  as 
fewer  or  more  of  them  may  be  prefent,  or  may  exift  with  a 
greater  or  lefs  degree  of  inactivity. 

2.  Now  as  the  capillaries  of  the  fkin  are  expofed  to  greater 
varieties  of  heat  and  cold,  than  the  heart  and  arteries,  they  are 
fuppofed  to  be  more  mobile,  that  is,  more  fufceptible  of  torpor 
or  exertion,  or  to  inflammation,  by  external  ftimuli  or  influences, 
than  the  other  parts  of  the  fanguiferous  fyftem  ;  and  as  the  fldn. 
is  more  fenfible  to  the  prefence  of  heat,  than  the  internal  parts 
of  the  body,  the  commencement  of  the  cold  paroxyfms  of  fever 
generally  either  firft  exifts  in,  or  is  firft  perceived  by,  the  cold- 
nefs  and  palenefs  of  the  fkin  j  and  the  commencement:  of  the  hot 
fits  by  the  heat  and  rednefs  of  it. 

3.  The  accumulation  of  fenforial  power  occurs  in  thefe  or- 
gans fooneft,  and  in  greateft  quantity,  during  their  quiefcence, 
which  were  mofl  perpetually  in  action  during  health  ;  hence 
thofe  parts  of  the  fyftem  fooneft  recover  from  torpor  in  inter- 
mittent fever,  and  fooneft  fall  into  the  contrary  extreme  of  in- 
creafed activity  ;  as  the  fanguiferous  fyftem  of  the  heart  and  ar- 
teries and  capillaries.     But  of  thefe  the  capillaries  feem  firft  to 
acquire  a  renovation  of  their  action,  as  the  heat  of  the  ikin  be- 
comes firft  renewed,   as   well  as   increafed  beyond  its   natural 
quantity,  and  this  in  fome   parts  fooner  than  in  others ;  whicli 
quantity  of  heat  is  however  not  to  be  eftimatcd  fimply  by  the 
rife  of  the  mercury  in  the  thermometer,  but  alfo  by  the  quanti- 
ty carried  away  into  the  atmofphere,  or  diffufed  amongft  other 
bodies  in  a  given  time ;    as   more  heat  paiFes  through   water, 
which  boils  vehemently,  than  when  it  boils  gently,  though  the 

rife 


.. 


4<  THEORY  OF  FEVER.          SUP.  I.  7. 

rife  of  the  thermometer  in  both  cafes  continues  the  fame.  This 
fact  may  he  known  by  boiling  an  egg  in  water,  the  white  of 
which  coagulates  in  much  lefs  time$  if  the  water  boils  vehement- 
ly, than  if  it  boils  moderately,  though  the  fenfible  heat  of  the 
water  is  the  fame  in  both  cafes. 

Another  caufe,  which  induces  the  cutaneous  capillaries  to  re- 
new their  actions  fooner  than  the  heart  and  arteries  after  im- 
merfion  In  the  cold  hath,  is,  that  their  torpor  was  occafioned  by 
defect  of  irritation  :  whereas  that  of  the  heart  and  arteries  was 
occafioned  by  defect  of  aflbciation  ;  which  defect  of  aflbciation 
was  owing  to  the  decreafed  actions  of  the  capillaries,  and  is  now 
again  excited  by  their  renewed  action  j  which  excitement  muft 
therefore  be  fubfequent  to  that  increafed  action  of  the  capilla- 
ries ;  and  in  confequence  the  increafed  action  of  the  heart  and 
arteries  at  the  commencement  of  the  hot  fit  of  fome  fevers  is 
fubfequent  to  the  increafed  action  of  the  cutaneous  capillaries. 
There  is,  however,  in  this  cafe  an  accumulation  of  the  fenforial 
power  of  aflbciation  in  the  heart  and  arteries,  which  muft  con- 
tribute to  increafe  their  orgafm  in  the  hot  fit,  as  well  as  the  in- 
creafed excitement  of  it  by  the  increafed  action  of  the  capillaries. 

4.  Now  this  increafed  action  of  the  fyftem,  during  the  hot 
fit,  by  exhaufting  the  fenforial  powers  of  irritation  and  aflbcia- 
tion, contributes  to  induce  a  renewal  of  the  cold  paroxyfm ;  as 
the  accumulation  of  thofe  fenforial  powers  in  the  cold  fit  pro- 
duces the  increafed  actions  of  the  hot  fit ;  which  two  flares  o£ 
the  fyftem  reciprocally  induce  each  other  by  a  kind  of  librations 
or  a  plus  and  minus,  of  the  fenforial  powers  of  irritation  and 
aflbciation. 

If  the  exhauftion  of  fenforial  power  during  the  hot  fit  of  fe- 
ver only  reduces  the  quantity  of  irritability  and  aflbciability  to 
its  natural  ftandard,  the  fever  is  cured,  not  being  liable  to  re- 
turn. If  the  quantity  of  thefe  fenforial  powers  be  reduced  only 
fo  much,  as  not  to  produce  a  fecond  cold  fit  during  the  prefent 
quantity  of  external  ftimuli  or  influences  ;  yet  it  may  be  fo  far 
reduced,  that  a  very  fmall  fubtraction  of  ftimulus,  or  of  influ- 
ence, may  again  induce  a  cold  fit  \  fuch  as  the  coldneis  of  the 
night.air,  or  the  diminution  of  folar  or  lunar  gravitation,  as  in 
intermittent  fevers. 

5.  Another  caufe  of  the  renovation  of  the  cold  fits  of  fever 
is  from  fome  parts  of  the  fyftem  not  having  completely  recov- 
ered from  the  former  cold  paroxyfm  ;  as  happens  to  the  fpleen, 
liver,  or  other  internal  vifcus ;  which  fometimes  remains  tumid, 
and  either  occafions  a  return  of  the  cold  fit  by  direct  fympathy 
with  other  parts  of  the  body«  or  by  its  own  want  of  action  cauf- 
cs  a  diminution  of  the  general  quantity  of  heat,  and  thus  facili- 
tates 


SUF.  I.  8.  i.          THEORY  OF  FEVER.  481 

tates  the  renovation  of  the  torpor  of  the  whole  iyftem,  and  gives 
caufe  to  intermittent  fevers  catenated  with  lunar  or  folar  influ- 
ence. 

VIII.    Orgafm  of  the  Capillaries. 

As  the  remaining  torpor  of  fome  lefs  effential  part  of  tke  fyf- 
tem,  as  of  the  fpleen,  when  the  hot  fit  ceafes,  produces  after 
one,  two,  or  three  days  a  return  of  cold  fit  by  direct  fympathy 
with  the  cutaneous  capillaries,  when  joined  with  fome  other 
caufe  of  torpor,  as  the  defedt  of  foiar  or  lunar  influences,  or  the 
expofure  to  cold  or  hunger,  and  thus  gives  origin  to  intermit- 
tent fever  ;  fo  the  remaining  torpor  of  fome  more  eifential  parts 
of  the  fyftern,  as  of  the  itomach  and  inteltines,  is  probably  the 
caufe  of  the  immediate  recurrence  of  the  cold  paroxyfm,  at  the 
time  the  hot  one  ceafes,  by  their  direct  fympathy  with  the  cu- 
taneous capillaries,  without  the  ailiftance  of  any  other  caufe  of 
torpor  ;  and  thus  produces  remittent  fever.  And  laflly  the  re- 
maining torpor  of  fome  dill  more  efiential  parts  of  the  fyftem, 
as  die  heart  and  arteries,  after  the  hot  fit  ought  to  ceafr,  is  lia- 
ble by  reverfe  fympathy  with  the  cutaneous  capillaries  to  con- 
tinue their  orgafm,  and  thus  to  render  a  fever  continual,  which 
would  otherwife  remit  or  intermit. 

Many  difficulties  here  -occur,  which  we  fliall  endeavour  to 
throw  fome  light  upon,  and  leave  to  future  investigation ;  ob- 
ferving  only  that  difficulties  were  to  be  expe&ed,  otherwife  fe- 
vers would  long  fince  have  been  understood,  as  they  have  em- 
ployed the  unremitted  attention  of  the  phyficians  of  all  ages  of 
the  world. 

i.  Why  do  the  fame  parts  of  fucceflive  trains  of  action  fome- 
times  affect  each  other  by  direcl:,  and  fometimes  by  reverfe  fym- 
pathy ? — i  ft,  When  any  irritative  motion  ceafes,  or  becomes 
torpid,  which  was  before  in  perpetuaJ  action  ;  it  is  either  de- 
prived of  its  ufuul  ftimulus,  and  thence  the  fenforial  power  of 
irritation  is  not  excited  ;  or  it  has  been  previoufly  too  much  ftim- 
uiated,  and  the  fenforial  power  has  been  thus  exhaufted. 

In  the  former  cafe  an  accumulation  of  fenforial  power  foon 
'  occurs,  which  is  excitable  by  a  renewal  of  the  ftimulus  ;  as  whert 
the  fingers,  which  have  been  immerfed  fome  time  in  inow,  are 
again  expofed  to  the  ufual  warmth  of  a  room.  Or,  fecondly,  the 
fenforial  power  of  irritation  becomes  fo  much  accumulated,  that 
the  motions,  which  were  torpid,  are  now  performed  by  idi 
ftimulus  than  natural ;  as  appears  by  the  warmth,  which  loon- 
occurs  after  the  firft  chill  in  going  into  frofly  air,  or  into  the 
bath  at  Buxton,  which  is  about  eighty  degrees  of  heat.  Or,- 

laftly, 


462  THEORY  OF  FEVER.          SUP.  I.  8.  2* 

hilly,  this  accumulation  of  the  fenforial  power  of  irritation  fo 
far  abounds,  that  it  increafes  the  action  of  the  next  link  of  the 
aifociated  train  or  tribe  of  motions  ;  thus  on  expofmg  the  fkin 
to  cold  air,  as  in  walking  out  in  a  frofty  morning,  the  actions 
of  the  ftomach  are  increafed,  and  digeftion  ftrengthened. 

But  where  the  torpor  of  fome  irritative  motion  is  owing  to 
the  previous  exhauftion  of  the  fenforial  power  of  irritation  by 
too  great  ftimulus,  the  reftoration  of  it  occurs  either  not  at  all, 
or  much  more  flowly  than  in  the  former  inftances ;  thus  after 
intoxication  the  ftomaclys  very  flow  in  recovering  its  due  quan- 
tity of  the  fenforial  power  of  irritation,  and  never  fhews  any  ac- 
cumulation of  it. 

2.  When  an  aflbciate  motion,  as  defcribed  in  the  introduc- 
tion to  Clafs  IV.  i.  i.  acts  with  lefs  energy,  the  fenforial  pow- 
er of  aflbciation  is  either  not  fufficiently  excited  by  the  preced- 
ing fibrous  motions ;  or  it  has  been  expended  or  exhaufted  by 
the  too  violent  actions  of  the  preceding  fibrous  motions.     In  the 
former  cafe  tbere  occurs  an  accumulation  of  the  fenforial  power 
of  aflbciation  ;  exactly  as,  where  the  ufual  ftimulus  is  with- 
drawn, there  occurs  an  accumulation  of  the  fenforial  power  of 
irritation.     Thus  when  the  actions  of  the  capillaries  of  the  fkin 
are  diminifhed  by  immerfion  in  cold  water,  the  capillaries  of  the 
lungs  are  rendered  torpid  by  the  want  of  the  excitement  of  the 
fenforial  power  of  aflbciation,  owing  to  the  leffened  actions  of  the 
previous  fibrous  motions,  namely,  of  thofe  of  the  fkin.     Never- 
thelefs  as  foon  as  the  capillaries  of  the  fkin  regain  their  increafed 
activity  by  the  accumulation  of  the  fenforial  power  of  irrita- 
tion, thefe  capillaries  of  the  lungs  act  with  greater  energy  alfo 
owing  to  their  accumulated  fenforial  power  of  aflbciation.    Thefe 
are  inftances  of  direct  fympathy,  and  conftitute  the  cold  and 
hot  paroxyfms  of  intermittent  fever ;  or  the  firft  paro-xyfm  of  a 
continued  one. 

3.  When  the  firft  link  of  a  train  of  aflbciated  motions,  which 
is  fubjeft  to  perpetual  action,  becomes  a  confiderable  time  tor- 
pid for  want  of  being  excited  by  the  previous  exertions -of  the 
irritative  motions,   with   which  it  is  catenated  ;  the  fenforial 
power  of  aflbciation  becomes  accumulated  in  fo  great  a  degree 
as  to  affect  the  fecond  link  of  the  train   of  aflbciated  motions, 
and  to  excke  it  into  ftronger  action.     Thus  when  the  ftomach 
is  rendered  torpid  by  contagious  matter  fwallowed  into  it  mixed 
with  the  faliva,  the  heart  and  arteries  act  more  feebly ;  becaufe 
the  fenforial  power  of  aflbciation,  which  ufed  to  be  excited  by 
the  fibrous  motions  of  the  ftomach,  is  not  now  excited  ;  and  in 
eonfequence  the  motions  of  the  heart  and  arteries  act  only  by 

the 


SUP.  I.  8. 4.          THEORY  OF  FEVER.  463 

the  fenforial  power  of  irritation,  which  is  excited  by  the  ftimu- 
lus  of  the  blood. 

But  during  this  torpor  of  the  ftomach,  and  lefs  aftion  of  th« 
heart  and  arteries,  fo  great  an  accumulation  of  the  fenforial 
powers  of  irritation  and  of  aflbciation  occurs,  that  it  adds  to  the 
action  of  the  next  link  of  this  vital  circle  of  actions,  that  is,  to 
that  of  the  cutaneous  capillaries.  Whence  in  this  fituation  the 
torpor  of  the  ftomach  occafions  a  diminimed  action  of  the  heart 
and  arteries  by  direct  fympathy,  and  may  be  faidto  occafion  an 
increafed  one  of  the  cutaneous  capillaries  by  reverfe  fympathy  ; 
which  conftitute  continued  fever  with  weak  pulfe. 

Nor  is  this  increafed  action  of  the  capillaries  in  confequence 
of  the  decreafed  action  of  the  heart  and  arteries,  as  in  fevers 
with  weak  pulfe,  a  fmgle  fact  in  the  animal  economy  ;  though 
it  exifts  in  this  cafe  in  the  greateft  degree  or  duration,  becaufe 
the  heart  and  arteries  are  perpetually  in  greater  action  than  any 
other  part  of  the  fyftem.  But  a  fimilar  circumftance  occurs, 
when  the  ftomach  is  rendered  inactive  by  defective  excitement 
of  the  fenforial  power  of  aflbciation,  as  in  fea-ficknefs,  or  in 
nephritis.  In  thefe  cafes  the  fenforial  power  of  aflbciation  be- 
comes much  accumulated  in  the  ftomach,  and  feems  by  its  fu- 
perabundance  to  excite  the  abforbent  fyftem,  which  is  fo  nearly 
connected  with  it,  into  great  increafe  of  action  ;  as  is  known  by 
the  great  quantity  frequently  in  thefe  fituations  rejected  by  vom- 
it, which  could  not  otherways  be  fupplied.  It  is  probable  the 
increafe  of  digeftion  by  walking  in  frofty  air,  with  many  other 
animal  facts,  may  by  future  observations  be  found  to  be  depend- 
ent on  this  principle,  as  well  as  the  increafed  action  of  the  ca- 
pillaries in  continued  fevers  with  weak  pulfe. 

Whereas  in  continued  fever  with  ftrong  pulfe,  which  may 
perhaps  occur  fometimes  on  the  firft  day  even  of  the  plague,  the 
ftomach  with  the  heart  and  arteries  and  the  capillaries  act  by 
direct  fympathy  j  that  is,  the  ftomach  is  excited  into  ftronger 
action  by  increafed  irritation  owing  to  the  ftimulus  of  conta- 
gious matter ;  thefe  ftronger  irritative  motions  of  the  ftomach 
excite  a  greater  quantity  of  the  fenforial  power  of  aflbciation, 
which  then  actuates  the  heart  and  arteries  with  greater  energy, 
as  thefe  are  catenated  with  the  ftomach  •,  and  in  the  fame  man- 
ner the  ircreafed  actions  of  the  heart  and  arteries  excite  a  great- 
er quantity  of  the  fenforial  power  of  aflbciation,  which  actuates 
the  cutaneous  capillaries  with  iwcreafe  of  energy.  See  Clafi 
IV.  i.  i. 

4.  I  (hall  dwell  a  little  longer  on  this  intricate  fubject.  The 
commencement  of  fever-fits  is  known  by  the  inactivity  of  the 
cutaneous  capillaries,  which  inactivity  is  obfervable  by  the  pale- 

riefs 


464  THEORY  OF  FEVER.  SUP.  1. 8.  j. 

nefs  and  coldnefs  of  the  (kin,  and  alfo  by  the  pain  of  coldnefs, 
which  attends  it.  There  is  neverthelefs  in  mod  cafes,  except 
tkofe  which  are  owing  to  expofure  to  external  cold,  a  torpor  of 
the  capillaries  of  fome  internal  vifcus  preceding  this  inactivity 
of  the  cutaneous  capillaries  ;  which  is  known  by  the  tumour  or 
hardnefs  of  the  vifcus,  or  by  an  aching  pain  of  it.  The  capilla- 
ries of  the  lungs  are  at  the  fame  time  rendered  inactive  or  tor- 
pid, as  appears  by  the  difficulty  of  breathing,  and  coldnefs  of 
the  breath  in  cold  fits  of  fever,  and  in  going  into  the  cold  bath  ; 
but  the  lungs  are  not  affected  with  the  pain  either  of  coldnefs  or 
of  torpor. 

One  caufe  of  this  fynchronous  or  fucceflive  inactivity  of  the 
cutaneous  capillaries,  in  confequence  of  the  previous  torpor  of 
fome  internal  vifcus,  may  be  owing  to  the  deficiency  of  heat ; 
which  muft  occur,  when  any  part  becomes  inactive ;  becauie 
the  fecretions  cf  that  part  ceafe  or  are  leffened,  and  the  quantity 
of  heat  of  it  in  confequence.  But  the  principal  caufe  of  it  I 
fuppofe  to  be  owing  to  the  defect  of  the  fenforial  power  of  af- 
fociation ;  which  power  of  affociation  is  excited  by  fome  pre- 
vious or  concomitant  motions  of  the  parts  of  every  great  circle 
of  actions.  This  appears  on  going  into  the  cold  bath,  becaufe 
the  fhortnefs  of  breath  inflantly  occurs,  fooner  than  one  can  con- 
ceive the  diminution  of  the  heat  of  the  fkin  could  affect  the  lungs 
by  the  want  of  its  llimulus  ;  but  not  fooner  than  the  defect  of  the 
fenforial  power  of  affociation  could  affect  diem  ;  becaufe  this 
mud  ceafe  to  be  excited  into  action  on  the  inftant  that  the  cu- 
taneous capillaries  ceafe  to  act  ;  whence  in  the  firft  moment  of 
contact  of  the  cold  water  the  cutaneous  capillaries  ceafe  to  act 
from  defect  of  irritation ;  which  is  caufed  by  defect  of  the  ftim- 
ulus  of  heat ;  and  in  the  fecond  moment  the  capillaries  of  the 
lungs  ceafe  to  act  from  the  defect  of  affociation  j  which  is  cauf- 
ed by  the  defect  of  the  motions  of  the  cutaneous  capillaries. 
Thus  the  univerfal  torpor  in  the  cold  paroxyfm  of  fever  is  an  ex- 
ample of  direct  fympathy,  though  occasioned  in  part  by  defect 
of  irritation,  and  in  part  by  defect  of  affociation. 

5.  Thus  in  walking  out  in  a  frofty  morning  the  fkin  is  cool- 
ed by  the  contact  of  the  cold  air,  whence  the  actions  of  its  ca- 
pillaries are  diminifhed  for  want  of  their  ufual  itimulus  of  heat 
to  excite  a  fufficient  quantity  of  the  fenforial  power  of  irritation. 
Hence  there  is  at  firft  a  faving  of  the  fenforial  power  of  irrita- 
tion for  the  purpofe  of  actuating  the  other  parts  of  the  fyflem. 
with  greater  energy.  Secondly,  the  fenforial  power  of  affocia- 
tion, which  ufed  to  be  excited  by  the  motions  of  the  cutar: 
capillaries,  is  now  not  fo  powerfully  excited  ;  and  in  confequenc^ 
rh<-  pirts..  \vhich  ronflitutc  the  nest  links  of  the  circles  of  aflb- 

ciated 


SUP.  1. 8. 6.  THEORY  OF  FEVER. 

ciated  motions,  are  for  a  time  actuated  with  lefs  energy,  and  £ 
temporary  general  chillnefs  fucceeds  ;  which  is  fo  far  fimilar  to 
the  cold  fit  of  intermittent  fever. 

In  this  fituation  there  is  a  curious  circumftance  occurs,  which 
merits  peculiar  attention  :  after  a  fhort  time,  though  the  exter- 
nal fjcin  continues  cool  by  its  expofure  to  the  cold  air,  and  the 
actions  of  its  capillaries  are  confequently  diminimed,  yet  the  ca- 
pillaries of  the  ilomach  act  with  greater  energy  j  as  is  known 
by  increafed  digeftion  and  confequent  hunger.  This  is  to  be 
afcribed  to  the  accumulation  of  the  fenforial  power  of  irritation, 
which  now  excites  by  its  fuperabundance,  or  overflowing",  as  it 
were,  the  ilomach  into  increafed  adtion  ;  though  it  is  at  the  fame 
time  excited  lefs  powerfully  than  ufual  by  the  fenforial  power  of 
aflbciation.  Thus  the  accumulation  of  the  fenforial  power  of 
irritation  in  the  veflels  of  the  fkin  increafes  in  this  cafe  the  ac- 
tion of  the  ftomach,  in  the  fame  manner  as  an  accumulation  of 
the  fenforial  power  of  aflbciation  in  the  heart  and  arteries  in  fe- 
vers with  weak  pulfe  increafes  the  action  of  the  capillaries. 

If  neverthelefs  the  coldnefs  of  the  fkin  be  too  long  continued, 
or  exifts  in  too  great  a  degree,  fo  as  in  fome  meafure  to  impair 
the  life  of  the  part,  no  further  accumulation  of  the  fenforial 
power  of  irritation  occurs  ;  and  in  confequence  the  actions  of 
the  ftomach  become  lefs  than  natural  by  the  defect  of  the  fen- 
forial power  of  aflbciation  ;  which  has  ceafed  to  be  excited  by 
the  want  of  a&ion  of  the  cutaneous  capillaries.  Whence  con- 
tinued coldnefs  of  the  feet  is  accompanied  with  indigeftion  and 
heartburn.  See  Clafs  IV.  2.  1.6* 

6.  Similar  to  this  when  the  actions  of  the  ftomach  are  ren- 
dered torpid  by  the  previous  ftimulus  of  a  violent  emetic,  and 
its  motions  become  retrograde  in  confequence,  a  great  quantity 
of  fenforial  power  is  exerted  on  the  lymphatics  of  the  lungs, 
and  other  parts  of  the  body ;  which  excites  them  into  greater 
direct  action,  as  is  evinced  by  the  exhibition  of  digitalis  in  ana- 
farca.  In  this  fituation  I  fuppofe  the  emetic  drug  (timulates  the 
mufcular  fibres  of  the  ftomach  into  too  great  action  ;  and  that 
in  confequence  a  great  torpor  foon  fucceeds  ;  and  that  this  in- 
action of  the  mufcular  parts  of  the  ftomach  is  not  followed  by 
much  accumulation  of  the  fenforial  power  of  irritation  ;  be- 
caufe  that  fenforial  power  is  in  great  meafure  exhaufted  by  the 
previous  exceflive  ftimulus.  But  the  lymphatics  of  the  ftom- 
ach have  their  actions  leflened  by  defect  of  fenforial  power 
of  aflbciation,  which  is  not  now  excited  into  action,  owing  to 
the  leflened  motions  of  the  mufcular  parts  of  it,  with  which  the 
lymphatics  are  aflbciated.  The  fenforial  power  of  aflbciation 
becomes  therefore  accumulated  in  thefe  lymphatics  of  the  ftom- 

VOL.  II,  M  M  m  acji, 


466  THEORY  OF  FEVER.  SUP.  1. 8. 7, 

ach,  becaufe  it  is  not  excited  into  action ;  exactly  as  the  power 
of  irritation  becomes  accumulated  in  the  hand,  when  immerfed 
in  fnow ;  and  this  accumulated  fenforial  power  of  afTociation 
excites  the  lymphatics  of  the  lungs  and  of  other  parts,  which  are 
moft  nearly  aflbciated  with  thofe  of  the  ftomach,  into  more  en- 
ergetic actions.  Thus  the  mufcular  fibres  of  the  ftomach  act 
with  the  lymphatics  of  that  organ  in  direct  fympathy ;  and  the 
lymphatics  of  the  ftomach  act  in  reverfe  fympathy  with  thofe  of 
the  lungs  and  of  other  parts  of  the  body  ;  the  former  of  which  is 
caufed  by  defect  of  the  excitement  of  the  fenforial  power  of  af- 
fociation,  and  the  latter  by  the  accumulation  of  it. 

Befides  the  efficient  caufe,  as  above  explained,  the  final  caufe> 
or  convenience,  of  thefe  organic  actions  are  worthy  our  atten- 
tion. In  this  cafe  of  an  acrid  drug  f wallowed  into  the  ftomach 
the  reverted  actions  of  the  mufcular  fibres  of  the  ftomach  tend 
to  eject  its  enemy ;  the  reverted  actions  of  its  lymphatics  pout 
ft  great  quantity  of  fluids  into  the  ftomach  for  the  piirpofe  of  di- 
luting or  wafhing  off  the  noxious  drug ;  and  the  increafed  ac- 
tions of  the  other  lymphatics  fupply  thefe  retrograde  ones  of  the 
ftomach  with  an  inconceivable  fupply  of  fluids,  as  is  feen  in 
Ileus  and  Cholera. 

7.  The  inquifitive  reader  will  excufe  my  continuing  this 
fubjectj  though  perhaps  with  fome  repetitions,  as  it  envelopes 
the  very  eflence  of  fever.  When  the  firft  link  of  a  train  of  ac- 
tions is  excited  by  exceflive  ftimulus,  or  excefiive  irritability,  and 
thus  acts  with  unufual  energy  by  the  increafed  quantity  of  irri- 
tation,  thefe  increafed  motions  excite  a  greater  quantity  of  the 
fenforial  power  of  aflbciation,  which  caufes  increafed  motions 
in  the  fecond  link,  which  is  catenated  with  the  firft  •,  and  then 
the  exceflive  action  of  this  fecond  link  excites  alfo  a  greater 
quantity  of  the  fenforial  power  of  aflbciation,  which  increafes 
the  motions  of  the  third  link  of  this  chain  of  aflbciation,  and 
thus  the  inereafe  of  the  ftimulus  on  the  irritative  motions,  to 
which  the  chain  of  aflbciation  is  catenated,  increafes  the  action 
of  the  whole  chain  or  circle  of  aflbciated  motions. 

After  a  time  the  irritative  motions  become  torpid  by  expendi- 
ture of  the  fenforial  power  of  irritation,  and  then  the  power  of 
aflbciation  alfo  becomes  lefs  exerted,  both  becaufe  it  has  been  in 
part  exhaufted  by  too  great  action,  and  is  now  lefs  excited  by 
the  leflened  action  of  the  irritative  motions,  which  ufed  to  ex- 
cite it.  Thefe  are  both  inflances  of  direct  fympathy,  and  fre- 
quently conftitute  the  cold  and  hot  fit  of  intermittents. 

But  th6ugh  the  accumulation  of  the  fenforial  power  of  irri* 
tation  during  the  quiefcence  of  fome  motion  owing  to  want  of* 
ftimulus  generally  induces  torpor  in  the  firft  link  of  the  train  of 

afibciated 


Sur.  I.  8. 8.  THEORY  OF  FEVER.  467 

aflbciated  motions  catenated  with  it ;  as  the  capillaries  of  the 
lungs  become  torpid  immediately  on  immerfion  of  the  fkin  into 
cold  water ;  yet  in  fome  fituations  an  orgafm  or  excefs  of  action 
is  produced  in  the  firft  link  of  the  aflbciated  motions  thus  cate- 
nated with  irritative  ones ;  as  ia  the  increafed  action  of  the 
ftomach,  when  the  fkin  is  for  a  time  expofed  to  cold  air  ;  which 
may  in  part  be  afcribed  to  the  genera}  increafe  of  action  of  the 
whole  fyftem,  owing  to  the  diminifhd  expenditure  of  fenforial 
power,  but  particularly  of  the  parts,  which  have  habitually  act- 
ed together  ;  as  when  one  arm  is  paralytic  the  other  is  liable  to 
more  frequent  or  almoft  continual  motion ;  and  when  one  eye 
becomes  blind  the  other  frequently  becomes  ftronger ;  which  is 
well  known  to  farriers,  who  are  faid  fometimes  to  deftroy  the 
fight  of  one  eye  to  ftrengthen  that  of  the  other  in  difeafed  horfes. 

Hence  there  is  fometimes  a  direct  fympathy,  and  fometimes 
a  reverfe  one  fucceeds  the  torpor  occafioned  by  defect  of  ftimu- 
lus,  the  latter  of  which  is  perhaps  owing  to  a  certain  time  be- 
ing required  for  the  production  of  an  accumulation  of  the  fen- 
forial power  of  irritation  by  the  nervous  branches  of  the  tor- 
pid organ  ;  which  accumulation  is  now  in  part  or  entirely  de* 
rived  to  the  next  link  of  the  aflbciation.  Thus  in  going  into  a 
coldifh  bath,  as  into  a  river  in  the  fummer  months,  we  at  firft 
experience  a  difficulty  of  breathing  from  the  torpid  action  of  the 
pulmonary  capillaries,  owing  to  the  deficient  excitement  of  the 
fenforial  power  of  aflbciation  in  confequence  of  the  torpor  of  the 
cutaneous  capillaries.  But  in  a  very  fhort  time,  as  in  one  minr 
ute,  the  fenforial  power  of  irritation  becomes  accumulated  by 
the  inactivity  of  the  cutaneous  capillaries  ;  and  as  its  fuperabun- 
dance  becomes  now  expended  on  the  pulmonary  capillaries,  the 
difficult  refpiration  ceafes ;  though  the  cutaneous  capillaries  con- 
tinue torpid  by  their  contact  with  the  cold  water,  and  confe- 
quently  the  fenforial  power  of  aflbciation,  which  ufed  to  con- 
tribute to  actuate  the  pulmonary  capillaries,  is  lefs  excited. 

8.  In  like  manner  when  there  exilts  an  accumulation  of  the 
fenforial  power  of  aflbciation,  owing  to  defect  of  its  excitement 
by  fome  previous  irritative  or  aflbciate  motions,  it  is  generally 
accompanied  for  a  certain  time  by  a  torpor  not  only  of  the  link 
firft  affected,  but  of  the  fubfequent  parts,  or  of  the  whole  train 
of  aflbciated  motions,  as  in  the  cold  fits  of  intermittent  fevers. 
Yet  after  a  time  an  increafed  action  of  the  next  links  of  aflbci- 
ated motions  fucceeds  the  torpor  of  the  firft,  as  the  abforbent 
veflels  of  the  lungs  act  more  violently  in  confequence  9f  the  de- 
ficient action  of  thofe  of  the  ftomach  ;  and  the  (kin  at  the  com- 
mencement of  ficknefs  is  pale  and  cold,  but  in  a  little  time  be- 
comes flufhed  and  warm. 

Thus 


468  THEORY  OF  FEVER.  Sup.  1. 8.  9. 

Thus  we  fee  in  aflbciate  motions,  which  are  rendered  torpid 
by  defect  of  excitement,  that  fometimes  a  direft,  and  fometimes 
a  reverfe  fympathy  fucceeds  in  the  fubfequent  links  of  the  chain. 
Put  I  believe  where  a  torpor  of  irritative  or  of  the  aflbciate  mo- 
tions is  caufed  by  a  previous  too  great  expenditure  or  exhauftion 
of  the  fenforial  powers  of  irritation  or  aflbciation,  no  increafe 
of  action  in  the  fubfequent  link  ever  occurs,  or  not  till  after  3 
very  long  time. 

Thus  when  the  ilomach  becomes  torpid  by  previous  violent 
exertion,  and  confequent  exhauftion  of  the  fenforial  power  of 
irritation,  as  after  intoxication  with  wine  or  opium,  or  after  the 
exhibition  of  fome  violent  emetic  drug,  the  torpor  is  communi- 
cated to  the  heart  and  arteries,  as  in  continued  fevers  with 
weak  pulfe.  But  where  the  torpor  of  the  ftomach  is  produced 
from  defective  aflbciation,  as  in  fea-ficknefs  ;  or  in  the  ficknefs 
which  occurs,  when  a  ftone  flimulates  the  ureter ;  no  torpor 
is  then  communicated  to  the  heart  and  arteries.  For  in  the 
former  cafe  there  is  no  accumulation  of  fenforial  power  in  the 
ftomach,  which  was  previoufly  exhaufted  by  too  great  ftimulus  5 
but  in  the  latter  cafe  the  accumulation  of  fenforial  power  in  the 
ftomach  during  its  torpor  is  evinced  by  this  circumftance  ;  that 
in  fea-licknefs  the  patients  eat  and  drink  voracioufly  at  inter- 
vals ;  and  the  pulfe  is  generally  not  affected  by  the  iicknefs  oc- 
cafioned  by  a  ftone  in  the  ureter.  For  the  action  of  the  ftom- 
ach is  then  leflened,  and  in  confequence  becomes  retrograde, 
not  owing  to  the  exhauftion  of  the  fenforial  power  of  irritation,  but 
to  the  want  of  excitement  of  the  fenforial  power  of  aflbciation  ; 
which  is  caufed  by  the  defective  action  of  the  ureter,  which  be- 
comes occafionally  torpid  by  the  great  ftimulus  of  the  ftone  it 
contains ;  or  which  is  caufed  by  the  great  exhauftion  of  fenfori- 
al power  by  the  pain  ;  which  affects  the  ureter  without  exciting 
inflammation,  or  increafed  action  of  it. 

9.  Thus  though  the  ftomach  after  the  great  ftimulus  of  in- 
toxication from  excefs  of  wine  or  opium  will  continue  many 
hours  without  accumulation  of  fenforial  power,  as  appears  from 
the  patient's  experiencing  no  appetite  at  the  intervals  of  fick- 
nefs  ;  yet  after  long  abftinence  from  food,  at  length  not  only 
the  exhaufled  quantity  of  fenforial  power  is  renewed,  but  an  ac- 
cumulation of  it  at  length  occurs, and  hungerreturns.  In  this  fitu- 
ation  the  ftomach  ia  generally  about  a  whole  day  before  it  regains 
its  ufual  powers  of  digeftion;  but  if  it  has  been  ftillmore  violently 
ftimulated,  and  its  actions  further  impaired,  a  ftill  more  perma- 
nent torpor,  along  with  a  continued  fever  with  weak  pulfe  is  liable 
to  occur  j  and  a  fourth  part,  or  a  half,  or  three- fourths,  or  a 

whole 


SUP.  I.  8.  10.        THEORY  OF  FEVER. 

whole  lunar  period  pafles,  before  it  recovers  its  due  irritability 
and  confequent  action. 

In  fimilar  manner,  after  a  perfon  has  been  confined  in  a  very 
warm  room  for  fome  hours,  the  cutaneous  capillaries,  with  their 
fecretory  and  abforbent  veflels,  become  exhaufted  of  their  fenfo- 
rial  power  of  irritation  by  the  too  great  violent  exertions  occa- 
(ioned  by  the  unufual  ftimulus  of  heat ;  and  in  coming  into  a 
colder  atmofphere  an  inactivity  of  the  cutaneous  veiTels  exifts  at 
firft  for  fome  time  without  accumulation  of  fenforial  power  ;  as 
is  (hewn  by  the  continuance  of  the  pain  of  cold  and  the  pale- 
nefs  ;  but  after  a  time  both  the  pain  of  cold  and  palenefs  van- 
ifh,  which  now  indicates  an  accumulation  of  the  fenforial  pow- 
er of  irritation,  as  lefs  degrees  of  heat  ftimulate  the  fyftem  into 
due  action. 

In  the  fame  manner,  after  any  one  has  been  fome  time  in  the 
fummer  funfhine,  on  coming  into  a  dark  cell  he  continues  much 
longer  before  he  can  clearly  diftinguifh  objects,  than  if  his  eyes 
had  only  been  previouily  expofed  to  the  light  of  a  cloudy  day  in 
winter ;  becaufe  the  fenforial  power  of  irritation,  and  confequent 
fenfation,  had  in  the  firft  cafe  been  previoufly  much  expended 
or  exhaufted ;  and  therefore  required  a  much  longer  time  be- 
fore it  could  be  produced  in  the  brain,  or  derived  to  the  cptic 
nerves,  in  fuch  quantity  as  to  reftere  the  deficiency,  and  to  caufe 
an  accumulation  of  it  j  whereas  in  the  latter  cafe  no  deficiency 
had  occurred. 

10.  Thus  the  accumulation  or  deficiency  of  fenforial  power 
in  a  torpid  organ,  which  had  previoufly  been  accuftomed  to  per- 
petual action,  depends  on  the  manner  in  which  it  becomes  tor- 
pid ;  that  is,  whether  by  great  previous  llimulus,  or  great  previ- 
ous excitement  of  the  power  of  aflbciation  ;  or  by  defect  of  its 
accuftomed  ftimulus,  or  of  its  accuftomed  excitement  of  the 
power  of  aflbciation.  In  the  former  cafe  the  fenforial  power  is  in 
an  exhaufted  ftate,  and  therefore  is  not  likely  to  become  fo  foon 
accumulated,  as  after  drunkennefs,  or  expofure  to  great  heat,  or 
to  great  light ;  in  the  latter  a  great  accumulation  of  fenforial 
power  occurs,  as  after  expofure  to  coldj  or  hunger,  or  darknefs. 

Hence  when  the  ftomach  continues  torpid  by  previous  vio- 
lent ftimulus,  as  in  the  exhibition  of  digitalis,  no  accumulation 
of  fenforial  power  of  irritation  fupervenes;  and  in  confequence 
the  motions  of  the  heart  and  arteries,  which  are  aflbciated  with 
thofe  of  the  ftomach,  become  weak,  and  flow,  and  intermittent, 
from  the  defect  of  the  excitement  of  the  fenforial  power  of  aflb- 
ciation. But  what  follows  ?  as  the  actions  of  the  heart  and  ar- 
teries are  leflened  by  the  deficient  action  of  the  fenforial  power 
of  aflbciation,  and  not  by  previous  increafed  excitement  of  it ; 

a 


470  THEORY  OF  FEVER.        SUP.  I.  8. 


. 


a  great  accumulation  of  the  fenforial  power  of  aflbciation  oo 
curs,  which  is  exerted  on  the  pulmonary  and  cutaneous  abforb- 
ents  by  reverfe  fympathy,  and  produces  a  great  abforption  of 
the  fluid  effufed  into  the  cellular  membrane  in  anafarca,  with 
dry  fkin ;  conftituting  one  kind  of  atrophy. 

But  if  at  the  fame  time  the  fecerning  veflels  of  the  ftomach 
are  ftimulated  into  fo  violent  activity  as  to  induce  great  confe- 
quent  torpor,  as  probably  happens  when  contagious  matter  is 
iwallowed  into  the  ftomach  with  our  faliva,  thofe  of  the  heart 
and  arteries  act  feebly  from  the  deficient  excitement  of  the  pow- 
er of  aflbciation  •,  and  then  the  cutaneous  and  pulmonary  fe- 
cerning veflels  act  with  greater  force  than  natural,  owing  to  the 
accumulation  of  the  fenforial  power  of  aflbciation  ;  and  unnatur- 
al heat  of  the  fkin,  and  of  the  breath  fucceed  5  but  without 
frequency  of  pulfe,  conftituting  the  parefis  irritativa  of  Clafs  I. 
2.  1.2.  And  laftly,  if  a  paucity  of  blood  attends  this  parefis  or 
fome  other  caufe  inducing  a  frequency  of  pulfe,  the  febris  inirri- 
tativa,  or  fever  with  weak  pulfe,  is  produced. 

But  on  the  contrary  when  the  ftomach  has  previoufly  been 
rendered  torpid  by  defect  of  ftimulus,  as  by  hunger,  if  food  be 
too  haftily  fupplied,  not  only  great  exertion  of  the  ftomach  it- 
felf  fucceeds,  but  fever  with  ftrong  pulfe  is  induced  in  confe- 
quence  ;  that  is,  the  heart  and  arteries  are  excited  into  more  en- 
ergetic action  by  the  excefs  of  the  power  of  aflbciation,  which 
catenates  their  motions  with  thofe  of  the  ftomach.  For  the  re» 
dundancy  of  fenforial  power  of  irritation,  which  was  accu- 
mulated during  the  inactivity  of  the  ftomach,  and  is  now  called 
into  action  by  ftimulus,  actuates  that  organ  with  kicreafed  en- 
ergy, and  excites  by  thefe  increafed  motions  the  fenforial  power 
of  aflbciation  ;  which  has  alfo  been  accumulated  during  the  in- 
activity of  the  heart  and  arteries ;  and  thus  thefe  organs  alfo  are 
now  excited  into  greater  action. 

So  after  the  fkin  has  been  expofed  fome  hours  to  greater  heat 
than  natural  in  the  warm  room,  other  parts  as  the  membranes 
of  the  noftrils,  or  of  the  lungs,  or  of  the  ftomach,  are  liable  to 
become  torpid  from  direct  fympathy  with  it,  when  we  come  in- 
to air  of  a  moderate  temperature ;  whence  catarrhs,  coughs, 
and  fevers.  But  if  this  torpor  be  occasioned  by  defect  of  ftim- 
lus,  as  after  being  expofed  to  frofty  air,  the  accumulation  of 
fenforial  power  is  exerted,  and  a  glow  of  the  Ikin  follows,  with 
increafed  digeftion,  full  refpiration,  and  more  vigorous  circu* 
lation. 

ii.  It  may  be  afked,  Why  is  there  a  great  and  conftant  accu- 
mulation of  the  fenforial  power  of  aflbciation,  owing  to  the  tor- 
por of  the  ftomach  and  heart  and  arteries,  in  continued  fever 

with 


SUP.  I.  8.  12.        THEORY  OF  FEVER.  471 

with  weak  pulfe  -,  which  is  exerted  on  the  cutaneous  and  pul* 
monary  capillaries,  fo  as  to  excite  them  into  increafed  action 
for  many  weeks,  and  yet  no  fuch  exuberance  of  fenforial  power 
produces  fever  in  winter-fleeping  animals,  or  in  chlorofis,  or 
apepfia,  or  hyfteria  ? 

In  winter-fleeping  animals  I  fuppofe  the  whole  nervous  fyf- 
tern  is  torpid,  or  paralyfed,  as  in  the  deep  of  frozen  people  5 
and  that  the  ftomach  is  torpid  in  confequence  of  the  inactivity 
or  quiefcence  of  the  brain  5  and  that  all  other  parts  of  the  body, 
and  the  cutaneous  capillaries  with  die  reft,  labour  under  a  Cm- 
ilar  torpor. 

In  chlorofis,  I  imagine,  the  actions  of  the  heart  and  arteriesi 
as  well  as  thofe  of  the  cutaneous  and  pulmonary  capillaries,  fuf- 
fer  along  with  thofe  of  the  ftomach  from  the  deficient  ftimulus 
of  the  pale  blood  ;  and  that  though  the  liver  is  probably  the  feat 
of  the  original  torpor  in  this  difeafe,  with  which  all  other  parts 
fympathize  from  defect  of  the  excitation  of  the  fenforial  power 
of  aflbciation  ;  yet  as  this  torpor  occurs  in  fo  fmall  a  degree  as  not 
to  excite  a  fhuddering  or  cold  fit,  no  obfervable  confequences  are 
in  general  occafioned  by  the  confequent  accumulation  of  fenfori- 
al power.  Sometimes  indeed  in  chlorofis  there  does  occur 
a  frequent  pulfe  and  hot  fkin ;  in  which  circumftances  I  fup- 
pofe the  heart  and  arteries  are  become  in  fome  degree  torpid  by 
direct  fympathy  with  the  torpid  liver ;  and  that  hence  not  on- 
ly the  pulfe  becomes  frequent,  but  the  capillaries  of  the  ikin  act 
more  violently  by  reverfe  fympathy  with  the  heart  and  arteries, 
owing  to  the  accumulation  of  the  fenforial  power  of  aflbciation 
in  them  during  their  torpid  ftate,  as  occurs  in  irritative  fever. 
See  Article  n.  of  this  Supplement- 

In  apepfia  chronica  the  actions  of  the  ftomach  are  not  fo  far 
impaired  or  deftroyed  as  totally  to  prevent  the  excitation  of  the 
fenforial  power  of  aflbciation,  which  therefore  contributes  fome- 
thing  towards  the  actions  of  the  heart  and  arteries,  though  lefs 
than  natural,  as  a  weak  pulfe  always  I  believe  attends  this  dif- 
eafe. 

There  is  a  torpor  of  the  ftomach,  and  of  the  upper  part  of 
the  alimentary  canal  in  hyfteria,  as  is  evident  from  the  retro- 
grade actions  of  the  duodenum,  ftomach,  and  cefophagus,  which 
conftitute  the  globus  hyftericus,  or  fenfation  of  a  globe  riling  in- 
to the  throat.  But  as  thefe  retrograde  action*  are  lefs  than  tl 
which  induce  ficknefs  or  vomiting,  and  are  not  o'ccalioned  by 
previous  exhauftiori  of  the  fenforial  power  of  irritation,  they  do 
not  fo  totally  prevent  the  excitement  of  the  fenforial  power  of 
laflbciation,  as  to  leflen  the  motion  of  the  heart  and  arteries  fo 
nauch  as  to  induce  fever  ;  yer  ia  this  cafe,  as  in  apepfia,  and  in 

cholorofis, 


THEORf  OF  FEVER.        SB*.  I.  8.  12. 

chlorofis,  the  pulfations  of  the  heart  and  arteries  are  weaker  than 
natural,  arid  are  fometimes  attended  with  occafionally  increafed 
action  of  the  capillaries ;  as  appears  from  the  flufhings  of  the 
face,  and  hot  fkin,  which  generally  form  an  evening  febricula  in 
difeafes  attended  with  weak  digeftion. 

12.  The  increafed  aclion,  or  orgafm,  of  the  cutaneous,  pul- 
monary, and  cellular  capillaries,  with  their  fecerning  and  abforb- 
cnt  veflels,  in  thofe  fevers  which  are  attended  with  deficiency 
of  vital  adHon,  exhaufts  the  patient  both  by  the  additional  ex- 
penditure of  fenforial  power  on  thofe  organs  of  fecretion,  and 
by  the  too  great  abforption  of  the  mucus  and  fat  of  the  body  ; 
whence  great  debility  and  great  emaciation.  Hence  one  great 
indication  of  cure  of  continued  fever  with  arterial  debility  is  to 
diminifh  the  too  great  aclion  of  the  capillaries  j  which  is  to  be 
done  by  frequent  ablutions,  or  bathing  the  whole  {kin  in  tepid  or 
in  cold  water,  as  recommended  by  Dr.  Currie  of  Liverpool 
(Philof.  Tranf.  for  1792),  for  half  an  hour,  twice  a  day,  or  at 
thofe  times  when  the  fkin  feels  dryeft  and  hotteft.  Much  cool 
air  fhould  alfo  be  admitted,  when  the  breath  of  the  patient  feels 
hot  to  one's  hand ;  or  when  the  tongue,  efpecially  its  middle 
part,  is  dry,  and  covered  with  a  cruft  of  indurated  mucus  ;  as 
thefe  indicate  the  increafed  aft  ion  of  the  pulmonary  capillaries  ; 
in  the  fame  manner  as  the  dry  and  hot  fkin  indicates  the  orgafm 
of  the  cutaneous  capillaries  5  and  the  emaciation  of  the  body 
that  of  the  cellular  ones. 

For  this  purpofe  of  abating  the  action  of  the  capillaries  by 
frequent  ablution  or  fomentation,  water  of  any  degree  of  heat 
beneath  that  of  the  body  will  be  of  fervice,  and  ought  in  accu- 
rate language  to  be  called  a  cold  bath  ;  but  the  degree  of  cold- 
nefs,  where  the  patient  is  fenfible,  mould  in  fome  meafure  be 
governed  by  his  fenfations ;  as  it  is  probable,  that  the  degree  of 
coldnefs,  which  is  moft  grateful  to  him,  will  alfo  be  of  the  great- 
eft  benefit  to  him.  See  Clafs  III.  2.  I.  12.  and  Article  15.  of 
this  Supplement. 

Another  great  ufe  of  frequent  ablutions,  or  fomentations,  or 
baths,  in  fevers,  where  the  ftomach  is  in  fome  degree  torpid,  is 
to  fupply  the  fyftem  with  aqueous  fluid  by  means  of  the  cutane- 
ous abforbents ;  which  is  diffipated  fafter  by  the  increafed  ac- 
tion of  the  fecerning  capillaries,  than  the  ftomach  can  furnifh, 
and  occafions  great  thirft  at  the  intervals  of  the  ficknefs. 

IX.   Torpor  of  the  Lungs. 

i .  The  lungs  in  many  cafes  of  contagion  may  firft  be  affect- 
ed with  torpor,  and  the  fkin  become  cold  by  fympathy ;  in  the 

fame 


bup.  1. 9.  2.          THEORY  OF  FEVER.  473 

fame  manner  as  a  cold  Ikin  on  going  into  the  cold  bath  induces 
difficulty  of  breathing.  Or  the  ftomach  may  become  affected 
with  torpor  by  its  fympathy  with  the  lungs,  as  in  the  experi- 
ments of  Mr.  Watt  with  hydrocarbonate  gas  j  a  few  refpira- 
tions  of  which  induced  ficknefs,  and  even  fyncope.  When  the 
ftomach  or  Ikin  is  thus  affected  fecondarily  by  aflbciation,  an 
accumulation  of  fenforial  power  occurs  much  fooner,  than  when 
thefe  parts  become  torpid  in  confequence  of  previous  excefs  of 
ftimulus  ;  and  hence  they  fooner  recover  their  accuftomed  ac- 
tion, and  the  fever  ceafes.  The  particles  of  contagious  matter 
thus  received  by  refpiration  fomewhat  refemble  in  their  effects 
the  acid  gales  from  burning  fulphur,  or  from  charcoal  ;  which, 
if  they  do  not  inftantly  deftroy,  induce  a  fever,  and  the  patient 
flowly  recovers. 

2-  I  was  fome  years  ago  Hooping  down  to  look,  which  way 
the  water  oozed  from  a  morafs,  as  a  labourer  opened  it  with  a 
fpade,  to  detect  the  fource  of  the  fpring,  and  inhaled  a  vapour, 
which  occafioned  an  inftant  fenfe  of  fuffbcation.  Immediately 
recoiling  I  believe  I  inhaled  it  but  once  ;  yet  a  few  hours  after- 
wards in  the  cool  of  the  evening,  when  I  returned  home  rather 
fatigued  and  hungry,  a  fhivering  and  cold  fit  occurred,  which 
was  followed  by  a  hot  one ;  and  the  whole  difeafe  began  an4 
terminated  in  about  twelve  hours  without  return.  In  this  cafe 
the  power  of  fear,  or  of  imagination,  was  not  concerned  j  as  I 
neither  thought  of  the  bad  air  of  a  morafs  before  I  perceived  it  j 
nor  expected  a  fever-fit,  till  it  occurred. 

In  this  cafe  the  torpor  commenced  in  the  lungs,  and  after  a 
few  hours,  by  the  addition  of  fatigue,  and  cold,  and  hunger, 
was  propagated  by  direct  fympathy  to  the  reft  of  the  fyitem. 
An  orgafm  or  increafed  action  of  the  whole  fyftem  was  then 
induced  by  the  accumulation  of  fenforial  power  of  irritation  in 
the  lungs,  and  of  aflbciation  in  the  other  organs ;  and  when 
thefe  fubfided,  the  difeafe  ceafed.  It  may  be  afked,  could  a  tor- 
por of  the  capillaries  of  the  air-vefTels  of  the  lungs  be  fo  fud- 
denly  produced  by  great  ftimulation  ? — It  appears  probable,  that 
it  might,  becaufe  great  exertion  of  irritative  motions  may  be  in- 
ftantly produced  without  our  perceiving  them  ;  that  is,  without 
their  being  attended  by  fenfation,  both  in  the  lungs  and  ftom- 
ach ;  and  the  organs  may  become  torpid  by  the  great  expendi- 
ture of  the  fenforial  power  of  itritation  in  an  inftant  of  time  5 
as  paralyfis  frequently  inftantly  follows  too  great  an  exertion  of 
voluntary  power. 

3.  When  the  capillaries  of  the  lungs  aft  too  violently,  as  in 
fome  continued  fevers ;  which  is  known  by  the  heat  of  the 
breath,  and  by  ihc  drynefs  of  the  tongue,  efpecially  of  the  mid- 

VOL.  II.  N  N  n  die 


... 


474  TI0ORY  OF  FEVER.        SUP.  I. 

I 

die  part  of  it ;  not  only  cooler  air  might  be  admitted  more  free- 
ly into  a  fick  room  to  counteract  this  orgafm  of  the  pulmonary 
capillaries  ;  but  perhaps  the  patient  might  breathe  with  advan- 
tage a  mixture  of  carbonic  acid  gas,  or  of  hydrogene  gas,  or  of 
azote  with  atmofpheric  air.  And  on  the  contrary,  when  there 
exifts  an  evident  torpor  of  the  pulmonary  capillaries,  which  may 
be  known  by  the  correfpondent  chillnefs  of  the  fkin  ;  and  by  a 
tickling  cough,  which  fometimes  attends  cold  paroxyfms  of  fe- 
ver, and  is  then  owing  to  the  deficient  abforption  of  the  pulmo- 
nary mucus,  the  faline  parts  of  which  ftimulate  the  bronchia?, 
or  air- veflels  ;  a  mixture  of  one  part  of  oxygen  gas  with  10  or 
20  parts  of  atmofpheric  air  might  probably  be  breathed  with 
great  advantage. 

X.  Torpor  of  the  Brain. 

As  the  inactivity  or  torpor  of  the  abforbent  veflels  of  the  brain 
is  the  caufe  of  hydrocephalus  internus ;  and  as  the  deficiency  of 
venous  abforption  in  the  brain,  or  torpor  of  the  extremities  of 
its  veins,  is  believed  frequently  to  be  the  caufe  of  apoplexies  i  fo 
there  is  reafon  to  conclude,  that  the  torpor  of  the  fecerning  vef- 
fels  of  the  brain,  which  are  fuppofed  to  produce  the  fenforial 
power,  may  conftitute  the  immediate  caufe  of  fome  fevers  with 
arterial  debility.  And  alfo  that  the  increafed  action  of  thefe  fe- 
cerning veflels  may  fometimes  conftitute  the  immediate  caufe  of 
fevers  with  arterial  ftrength. 

It  is  neverthelefs  probable,  that  the  torpor  or  orgafm  of  the 
fanguiferous,  abforbent,  or  fecerning  veflels  of  the  brain,  may 
frequently  exift  as  a  fecondary  effect,  owing  to  their  aflbciation 
\vith  other  organs,  as  the  ftomach  or  lungs  ;  and  may  thus  be 
produced  like  the  torpor  of  the  heart  and  arteries  in  inirritative 
fevers,  or  like  the  orgafm  of  thofe  organs  in  irritative  fevers,  or 
inflammatory  ones. 

Where  there  exifts  a  torpor  of  the  brain,  might  not  very 
(light  electric  (hocks  pafled  frequently  through  it  in  all  direc- 
tions be  ufed  with  advantage  ?  Might  not  fomentations  of  94 
or  96  degrees  of  heat  on  the  head  for  an  hour  at  a  time,  and  fre- 
queatly  repeated,  ftimulate  the  brain  into  action  ;  as  in  the  re- 
vival of  winter-fleeping  animals  by  warmth  ?  Ether  externally 
might  be  frequently  applied,  and  a  blifter  on  the  fhaved  head. 

Where  the  fecerning  velTels  of  the  brain  act  with  too  great 
energy,  as  in  fome  inflammatory  fevers,  might  it  not  be  dimin- 
ifhed  by  laying  the  patient  horizontally  on  a  mill-done,  and 
whirling  him,  till  fleep  fhould  be  produced,  as  the  brain  be- 
comes 


SUP.  I.  ii.  i.          THEORY  OF  FE\PR.  47 $ 

4 

comes  comprefled  by  the  centrifugal  force  ?  See  Article  15.  of 
this  Supplement. 

XI.  Torpor  of  the  Heart  and  Arteries. 

1.  It  was  (hewn  in  Clafs  IV.  i.  I.  6.  in  IV.  2.  I.  2.  and  in 

Suppl.  1.6.  3.  that  areverfe  fympathy  generally  exifts  between 
the  lacteal  and  lymphatic  branches  of  the  abforbent  fyftem. 
Hence,  when  the  motions  of  the  abforbents  of  the  ftomach  are 
rendered  torpid  or  retrograde  in  fevers  with  arterial  debility, 
thofe  of  the  Ikin,  lungs,  and  cellular  membrane,  aft  with  in- 
creafed  energy.  But  the  actions  of  the  mufcular  fibres  of  the 
heart  and  arteries  are  at  the  fame  time  aflbciated  with  thofe  of 
the  mufcular  fibres  of  the  ftomach  by  direct  fympathy.  Both 
thefe  actions  occur  during  the  operation  of  powerful  emetics, 
as  fquill,  or  digitalis ;  while  the  motions  of  the  ftomach  con- 
tinue torpid  or  retrograde,  the  cellular  and  cutaneous  abforbents 
act  with  greater  energy,  and  the  pulfatiens  of  the  heart  and  ar- 
teries become  weaker,  and  fometimes  flower. 

2.  The  increafed  action  of  the  ftomach  after  a  meal,  and  of 
the  heart  and  arteries  at  the  fame  time  from  the  ftimulus  of  the 
new  fupply  of  chyle,  feems  originally  to  have  produced,  and  to 
have  eftablifhed  this  direct  fympathy  between  them.     As  the 
increafed   action  of  the  abforbents  of  the  ftomach  after  a  meal 
has  been  ufually  attended  with  diminifhed  action  of  the  other 
branches  of  the  abforbent  fyftem,  as   mentioned  in  Clafs  IV. 
i.   i.  6.  and  has  thus  eftablifhed  a  reverfe  fympathy  between 
them. 

2.  Befides  the  reverfe  fympathy  of  the  abforbent  vellels  and  the 
mufcles  of  the  ftomach,  and  of  the  heart  and  arteries,  with  thofe 
of  the  Ikin,  lungs,  and  cellular  membrane ;  there  exifts  a  fimilar 
reverfe  fympathy  between  the  fecerning  veflels  or  glands  of  the 
former  of  thefe  organs  with  thofe  of  the  latter  ;  that  is  the  mu- 
cous glands  of  the  heart  and  arteries  act  generally  by  direct  fym- 
pathy with  thofe  of  the  ftomach ;  and  the  mucous  glands  of 
the  cellular  membrane  of  the  lungs,  and  of  the  (kin,  act  by  re- 
verfe fympathy  with  them  both. 

Hence  when  the  ftomach  is  torpid,  as  in  ficknefs,  this  torpor 
fometimes  only  affects  the  abforbent  veflejs  of  it ;  and  then  the 
abforbents  of  the  cellular  membrane  and  the  {kin  only  act  with 
increafed  energy  by  reverie  fympathy.  If  the  torpor  affects  the 
mufcular  fibres  of  the  ftomach,  thofe  of  the  heart  and  arteries 
act  by  direct  fympathy  with  it,  and  a  weak  pulfe  is  produced, 
as  in  the  exhibition  of  digitalis,  but  without  increaie  of  heat. 
But  if  the  torpor  alfo  affects  the  glands  of  the  ftomach,  the  cu- 
taneous 


476  THlbRY  OF  FEVER.          SUP.  I.  1 1. 3. 

taneous  and  pulmonary  glands  aft  with  greater  energy  by  their 
reverfe  fympathy  with  thofe  of  the  ftomach,  and  of  the  heart 
and  arteries  ;  and  great  heat  is  produced  along  with  increafed 
perfpiration  both  from  the  flcin  and  lungs. 

3.  There  is  fome  difficulty  in  explaining,  why  the  actions  of 
the  extenfive  fyftem  of  capillary  glands,  which  exift  on  every 
other  membrane  and  cell  in  the  body  for  the  purpofe  of  fecreting 
mucus  and  perfpirable  matter,  fliould  fo  generally  act  by  reverfe 
fympathy  with  thofe  of  the  ftomach  and  upper  part  of  the  in- 
teftines.     It  was  (hewn  in  Clafs  IV.  i.  1.6.  that  when  the  ftom- 
ach was  filled  with  folid  and  fluid  aliment,  the  abforbents  of  the 
cellular  membrane,  and  of  the  bladder,  and  of  the  flcin,  acted 
with  lefs  energy ;  as  the  fluids,  they  were  ufed  to  abforb  and 
tranfmit  into  the  circulation,  were  now  lefs  wanted ;  and  that 
hence  by  habit  a   reverfe   fympathy  obtained    between  thefe 
branches  of  the  abforbents  of  the  alimentary  canal,  and  thofe  of 
the  other  parts  of  the  body. 

Now,  as  at  this  time  lefs  fluid  was  abforbed  by  the  cutane- 
ous ^and  cellular  lymphatics,  it  would  happen,  that  lefs  would 
be  fecreted  by  their  correfpondent  fecerning  veflels,  or  capillary 
glands  ;  and  that  hence  by  habit,  thefe  fecerning  veflels  would 
acquire  a  reverfe  fympathy  of  action  with  the  fecerning  veflels 
of  the  alimentary  canal. 

Thus  when  the  abforption  of  the  tears  by  the  puncta  lacry- 
malia  is  much  increafed  by  the  ftimulus  of  fnufF;  or  of  an  af- 
fecting idea,  on  the  nafal  ducts,  as  explained  in  Sect.  XVI.  8. 
2.  a  great  increafe  of  the  fecretion  of  tears  from  the  lacrymal 
glands  is  produced  by  the  direct  fympathy  of  the  action  of  thefe 
glands  with  thofe  of  their  correfpondent  abforbents  ;  and  that 
though  in  this  cafe  they  are  placed  at  fo  great  a  diflance  from 
each  other. 

4.  A  difficult  queftion  here  occurs  ;  why  does  it  happen,  that 
in  fevers  with  weak  pulfe  the  contractions  of  the  heart  and  ar- 
teries become  at  the  fame  time  more  frequent ;  which  alfo  fome- 
times  occurs  in  chlorofis,  and  in  fome  hyfteric  and  hypochon- 
driac difeafes,  and  in  fome  infanitie$  ;  yet  at  other  times  the 
weak  pulfe  becomes  at  the  fame  time  flow,  as  in  the  exhibition 
of  digitalis,  and  in  parefis irritativa,  defcribed  in  Clafs  I.  2.  i.  2. 
which  may  be  termed  a  fever  with  flow  pulfe  ?  this  frequency 
of  pulfe  cannot  depend  on  heat,  becaufe  it  fometimes  exifts 
without  heat,  as  towards  the  end  of  fome  fevers  with  debility. 

Now  as  apoplexies,  which  are  fometimes  afcribed  to  fulnefs 
of  blood,  are  attended  with  flow  pulfe  ;  and  as  in  animals  dy- 
ing in  the  flaughter-houie  from  deficiency  of  blood  the  pulfe  be- 
comes frequent  in  extreme  ;  may  not  the  frequency  of  pulfe  in 

fevers 


SUP.  I.  ii.  5.         THEORY  OF  FETOR.  477 

fevers  with  arterial  debility  be  in  general  owing  to  pauci- 
blood  ?  as  explained  in  Sett.  XXXII.  2.  3.  and  its  11 
parefis  irritativa  be  cauled  by  the  debility  being  accv 
with  due  quantity  of  blood  ?    or  may  not  the  former  cirx 
fiance  fometimes  depend  on  a  concomitant  affection  of  the  brain 
approaching  to  ileep  ?  or  to  the  unufual  facility  of  the  paflage 
of  the  blood  through  the  pulmonary  and  aortal  capillaries  ?  in 
which  circumftance  the  heart  may  completely  empty  itfelf  at 
each  pulfation,  though  its  contractions  may  be  weak.     While 
the  latter  depends  on  the  difficulty  of  the  pafTage  of  the  blood 
through  the  pulmonary  or  aortal  capillaries,  as  in  the  cold  fits 
of  intermittents,  and  in  fome  palpitations  of  the  heart,  and  in 
fome  kinds  of  haemoptoe  ;  in  thefe  cafes  the  increafed  refinance 
prevents  the  heart  from  emptying  itfeif,  and  in  confequence  a 
new  diaftole  fooner  occurs,  and  thus  the  number  of  pulfations 
becomes  greater  in  a  given  time. 

5.  In  refpect  to  the  fympathies  of  action,  which  produce  or 
conftitute  fever  with  debility,  the  fyftcm  may  be  divided  into 
certain  provinces,  which  are  efientient  *br  oppofite  to  each  oth- 
er. Firlt,  the  lacteals  or  abforbent  veflels  of  the  ilomach,  and 
upper  part  of  the  inteftines  ;  fecondly,  the  lymphatics  or  all  the 
other  branches  of  the  abforbent  veflels,  which  arife  from  the 
Jkin,  mucous  membranes,  cellular  membranes,  and  the  various 
glands.  Thefe  two  divifions  act  by  reverie  fympathy  with  each 
other  in  the  hot  fits  of  fever  with  debility,  though  by  direct 
fympathy  in  the  cold  ones.  The  third  division  confifts  of  the 
fecerning  veflels  of  the  Ilomach  and  upper  intcftinea  ;  and  the 
fourth  of  the  fecerning  veflels  of  all  the  other  parts  of  the  body, 
as  the  capillary  glands  of  the  flcin,  lungs,  and  cellular  membrane, 
and  the  various  other  glands  belonging  to  the  fanguiferous  lyr- 
tem.  Many  of  thefe  frequently,  but  the  capillaries  always,  act 
by  reverfe  fympathy  with  thofe  of  the  third  divifion  above  men- 
tioned in  the  hot  fits  of  fever  with  debility,  though  by  direct 
fympathy  with  them  in  the  cold  fits.  Fifthly,  the  mufcular  fi- 
bres of  the  ilomach,  and  upper  inteftines  ;  and  fixthly,  the  muf- 
cular fibres  of  the  heart  and  arteries.  The  actions  of  thefe 
two  laft  divifions  of  moving  fibres  act  by  direct  fympathy  with 
each  other,  both  in  the  cold  and  hot  fits  of  fevers  with  debility. 

The  efficient  caufe  of  thofe  apparent  fymr.athies  in  fevers 
with  weak  pulfe  may  be  thus  underftood.  In  the  cold  paroxyfm 
of  fever  with  weak  pulfe  the  part  firft  affected  I  believe  to  be 
the  ftomach,  and  that  it  has  become  torpid  by  previous  violent 
exertion,  as  by  (wallowing  contagious  matter  mixed  with  faliva, 
and  not  by  defect  of  ftimulus,  as  from  cold  or  hunger.  The 
actions  of  this  important  organ,  which  fympathizes  withalmoft 

every 


4)8  THEORY  OF  FEVER.          SUP.  I.  n.  6. 

every  part  of  the  body,  being  thus  much  diminifhed  or  nearly 
deftroyed,  the  fenforial  power  of  affociation  is  not  excited  ; 
which  in  health  contributes  to  move  the  heart  and  arteries,  and 
all  the  reft  of  the  fyftem  ;  whence  an  univerfal  torpor  occurs. 

When  the  hot  fit  approaches,  the  ftomach  in  fevers  with 
ftrong  pulfe  regains  its  activity  by  the  accumulation  of  the  fen- 
forial power  either  of  irritation,  if  it  was  the  part  firit  affected, 
or  of  affociation  if  it  was  affected  in  fympathy  with  fome  other 
torpid  part,  as  the  fpleen  or  liver  ;  which  accumulation  is  pro- 
duced during  its  torpor.  At  the  fame  time  all  the  other  parts 
of  the  fyftem  acquire  greater  energy  of  action  by  the  accumula- 
tion of  the  fenforial  power  of  affociation,  which  was  produced, 
during  their  inactivity  in  the  cold  fit. 

But  hi  fevers  with  weak  pulfe  the  ftomach,  in  which  the  fen- 
forial power  of  irritation  had  been  previoufly  exhaufted  by  vio- 
lent action,  acquires  no  fuch  quick  accumulation  of  fenforial 
power,  but  remains  in  a  ftate  of  torpor  after  the  hot  fit  com- 
mences. The  heart  and  arteries  remain  alfo  in  a  ftate  of  tor- 
por, becaufe  there  continues  to  be  no  excitement  of  their  power 
of  affociation  owing  to  the  torpid  motions  of  the  ftomach  ;  but 
hence  it  happens,  that  there  exifts  at  this  time  a  great  accumu- 
lation of  the  power  of  affociation  in  the  lefs  active  fibres  of  the 
heart  and  arteries ;  which,  as  it  is  not  excited  and  expended  by 
them,  increafes  the  affociability  of  the  next  link  of  the  affociated 
chain  of  motions,  which  confifts  of  the  capillaries  or  other 
glands ;  and  that  in  fo  great  a  degree  as  to  actuate  them  with 
unnatural  energy,  and  thus  to  produce  a  perpetual  hot  fit  of  fe- 
ver. Becaufe  the  affociability  of  the  capillaries  is  fo  much  in- 
creafed  by  the  accumulation  of  this  power,  owing  to  the  leffen- 
ed  activity  of  the  heart  and  arteries,  as  to  over-balance  the  lef- 
fened  excitement  of  it  by  the  weaker  movements  of  the  heart 
and  arteries. 

6.  When  the  accumulation  of  the  fenforial  power  of  irrita- 
tion caufed  by  defect  of  ftimulus  is  greater  in  the  firft  link  of  a 
train  of  actions,  to  which  affociated  motions  are  catenated,  than 
the  deficiency  of  the  excitement  of  the  fenforial  power  of  affocia- 
tion in  the  next  link,  what  happens  ? — the  fuperabundance  of  the 
unemployed  fenforial  power  of  the  firft  link  is  derived  to  the 
fecond  ;  the  affociability  of  which  thus  becomes  fo  greatly  in- 
creafed,  that  it  a£ts  more  violently  than  natural,  though  the  ex- 
citement of  its  power  of  affociation  by  the  leffened  action  of  the 
firft  link  is  lefs  than  natural.  So  that  in  this  fituation  the  with- 
drawing of  an  accuftomed  ftimulus  in  fome  parts  of  the  fyftem 
will  decreafe  the  irritative  motions  of  that  part,  and  at  the  fame 

time 


SUP.  I.  1 1. 6.          THEORY  OF  FEV&R.  479 

time  occafion  an  increafe  of  the  aflbciate  motion  of  another  part, 
which  is  catenated  with  it. 

This  circumftance  neverthelefs  can  only  occur  in  thofe  parts 
of  the  fyftem,  whofe  natural  actions  are  perpetual,  and  the  ac- 
cumulation of  fenforial  power  on  thai  account  very  greai, 
when  their  activity  is  much  leflened  by  the  deduction  of  their 
ufual  ftimulus  ;  and  are  therefore  only  to  be  found  in  the  fan- 
guiferous  fyftem,  or  in  the  alimentary  canal,  or  in  the  glands  and 
capillaries.  Of  the  firft  of  which  the  following  is  an  inftance. 

The  refpiration  of  a  reduced  atmofphere,  that  is  of  air  mixed 
with  hydrogene  or  azote,  quickens  the  pulfe,  as  obferved  in  the 
cafe  of  Mrs.  Eaton  by  Dr.  Reynolds  and  Dr.  Thornton ;  to 
which  Dr.  Beddoes  adds  in  a.  note,  that  "  he  never  faw  au  in- 
ftance in  which  a  lowered  atmofphere  did  not  at  the  moment 
quicken  the  pulfe,  while  it  weakened  the  action  of  the  heart 
and  arteries."  Confiderations  on  Factitious  Airs,  by  Thomas 
Beddoes  and  James  Watt,  Part  III.  p.  67.  Johnfon,  London. 
By  the  afliftance  of  this  new  fact  the  curious  circumftance  of 
the  quick  production  of  warmth  of  the  Ikin  on  covering  the 
head  under  the  bed-clothes,  which  every  one  muft  at  fome  time 
have  experienced,  receives  a  more  fatisfactory  explanation,  than 
that  which  is  given  in  Clafs  IV.  I.  i.  2.  which  was  printed 
before  this  part  of  Dr.  Beddoes's  Confiderations  was  publilhed. 

For  if  the  blood  be  deprived  of  its  accuftomed  quantity  of  ox- 
ygen, as  in  covering  the  head  in  bed,  and  thus  breathing  an  air 
rendered  impure  by  repeated  refpiration,  or  by  breathing  a  fac- 
titious air  with  lefs  proportion  of  oxygen,  which  in  common  ref- 
piration pafles  through  the  moift  membranes  of  the  lungs,  and 
mixes  with  the  blood,  the  pulfations  of  the  heart  and  arteries 
become  weaker,  and  confequently  quicker,  by  the  defect  of  the 
itimulus  of  oxygen.  And  as  thefe  veflels  are  fubject  to  perpet- 
ual motion,  the  accumulation  of  the  fenforial  power  of  irrita- 
tion becomes  fo  great  by  their  leflened  activity,  that  it  excites 
the  veflels  next  connected,  the  cutaneous  capillaries  for  inftance, 
into  more  energetic  actions,  fo  as  to  produce  increafed  heat  of 
the  (kin,  and  greater  perfpiration. 

How  exactly  this  refembles  a  continued  fever  with  weak  and 
quick  pulie  ! — in  the  latter  the  action  of  the  heart  and  arteries 
are  leflened  by  defect  of  the  excitement  of  the  fenforial  power  of 
aflbciation,  owing  to  the  torpor  or  leflened  actions  of  the  ftoni- 
ach ;  hence  the  accumulation  of  the  fenforial  power  of  aflbcia- 
tion in  this  cafe,  as  the  accumulation  of  that  of  irritation  in  the 
former,  becomes  fo  abundant  as  to  excite  into  increafed  action 
the  parts  moft  nearly  connected,  as  the  cutaneous  capillaries. 

la  refpect  to  the  circumftance  mentioned  by  Sydenham,  that 

covering 


4  So  THEORY  OF  FEVER.        SUP.  I.  11.  7. 

covering  the  head  in  bed  in  a  fliort  time  relieved  the  pertina- 
cious ficknefs  of  the  patient,  it  in  nil  be  obferved,  that  when  the 
action  of  the  heart  and  arteries  becomes  weakened  by  the  want 
of  the  due  ftimulus  of  the  proper  quantity  of  oxygen  in  the 
blood,  an  accumulation  of  the  fenforial  power  of  irritation  oc- 
curs in  the  fibres  of  the  heart  and  arteries,  which  then  is  ex- 
pended on  thofe  of  the  capillary  glands,  increafing  their  actions 
and  confequent  fecretions  and  heat.  And  then  the  flornach  is 
thrown  into  flronger  action,  both  by  the  greater  excitement  of 
its  natural  quantity  of  the  fenforial  power  of  afibciation  by  the 
increafed  actions  of  the  capillaries,  and  alfo  by  fome  increafe  of 
aflbciability,  as  it  had  been  previoufly  a  long  time  in  a  Mate  of 
torpor,  or  lefs  activity  than  natural,  as  evinced  by  its  perpetual 
ficknefs. 

In  a  manner  fomewhat  ilmilar  to  this,  is  the  rednefs  of  the 
Ikin  produced  in  angry  people  by  the  fuperabundance  of  the  un- 
employed fenforial  power  of  volition,  as  explained  in  Clafs  IV. 
2.  3.  5.  Rubor  ex  irft.  From  hence  we  learn  how,  when 
people  in  fevers  with  weak  pulfe,  or  in  dropfies,  become  infane, 
the  abundance  of  the  unemployed  fenforial  power  of  volition 
increafes  the  actions  of  the  whole  moving  fyftem,  and  cures 
thofe  difeafes. 

7.  As  the  orgafm  of  the  capillaries  in  fevers  with  weak  pulfe 
is  immediately  caufed  by  the  torpid  actions  of  the  heart  and  ar- 
teries, as  above  explained,  this  fupplies  us  with,another  indica- 
tion 'of  cure  in  fuch  fevers,  and  that  is  to  (limulate  thefe  organs. 
This  may  probably  be  done  by  fome  kind  of  medicines,  which 
are  known  to  pafs  into  the  blood  unchanged  in  fome  of  their 
properties.  It  is  poffibie  that  nitre,  or  its  acid,  may  pafs  into  the 
blood  and  increafe  the  colour  of  it,  and  thus  increafe  its  ftimu- 
lus, and  the  fame  may  be  fuppofed  of  other  falts,  neutral  or  me- 
talic  ?  As  rubia  tinctoria,  madder,  colours  the  bones  of  young 
animal Sj  it  muft  pafs  into  the  blood  with  its  colouring  matter 
at  leait  unchanged,  and  perhaps  many  other  medicines  may 
iikewife  affe£t  the  blood,  and  thus  act  by  ftimulating  the  heart 
and  arteries,  as  well  as  by  ftimulating  the  ftomach  ;  which  cir- 
cumftance  deferves  further  attention. 

Another  way  of  immediately  ftimulating  the  heart  and  arte- 
ries would  be  by  transfufing  new  blood  into  them.  Is  it  pofliblc 
that  any  other  .fluid  befides  blood,  as  chyle,  or  milk,  or  water, 
could,  if  managed  with  great  art,  be  introduced  fafely  or  advan- 
tageoufly  into  the  vein  of  a  living  animal  ? 

"A  third  method  of  exciting  the  heart  and  arteries  immediate- 
ly is  by  increafing  the  natural  ftimulus  of  the  blood,  and  is  well 
worthy  experiment  in  all  fevers  with  weak  pulfe  j  and  that  con- 
fids 


SUP.  I.  12.  i.          THEORY  OF  FEVER,  481 

fids  in  (applying  the  blood  with  a  greater  proportion  of  oxygen  ; 
which  may  be  done  by  refpiradon,  if  the  patient  was  to  breathe 
cither  oxygen  gas  pure,  or  diluted  with  atmofpheric  air,  which 
might  be  given  to  many  gallons  frequently  in  a  day,  and  by 
patting  through  the  moift  membranes  of  the  lungs,  according  to 
the  experiments  of  Dr.  Prieftley,  and  uniting  with  the  blood, 
might  render  it  more  ftimulant,  and  thus  excite  the  heart  and 
arteries  into  greater  action  !  May  not  fome  eaGer  method  of 
exhibiting  oxygen  gas  by  refpiration  be  difcovered,  as  by  ufmg 
very  fmall  quantities  of  hyper-oxygenated  marine  acid  gas  very 
much  diluted  with  atmofpheric  air  ? 

XII.  Torpor  of  the  Stomach  and  upper  Inteftines. 

1.  The  principal  circumftance,  which  fupports  the  increafed 
action  of  the  capillaries  in  continued  fever  with  weak  pulfe,  is 
their  reverfe  fympathy  with  thofe  of  the  ftomach  and  upper  in- 
teftines,  or  with  thofe  of  the  heart  and  arteries.     The  torpor  of 
the  ftomach  and  upper  inteftines  is  apparent  in  continued  fevers 
from  the  total  want  of  appetite  for  folid  food,  befide  the  fick- 
nefs  with  which  fevers  generally  commence,  and  the  frequent 
diarrhoea  with  indigefted  ftools,  at  the  fame  time  the  third  of 
the  patient  is  fometimes  urgent  at  the  intervals  of  the  ficknefs. 
Why  the  ftomach  can  at  this  time  take  fluids  by  intervals,  and 
not  iblids,  is  difficult  to  explain  ;  except  it  be  fuppofed,  as  fome 
have  affirmed,  that  the  lacteal  abforbents  are  a  different  branch 
from  the  lymphatic  abforbents,  and  that  in  this  cafe  the  former 
only  are  in  a  ftate  of  permanent  torpor. 

2.  The  torpor  of  the  heart  and  arteries  is  known  by  the 
weaknefs  of  the  pulfe.     When  the  actions  of  the  abforbents  ut 
the  ftomach  are  diminimed  by  the  exhibition  of  fmall  dofes  of 
digitalis,  or  become  retrograde  by  larger  ones,  the  heart  and  ar- 
teries a£t  more  feebly  by  direct  fympathy  ;  but  the  cellular,  cu- 
taneous, and  pulmonary  abforbents  are  excited  into  greater  ac- 
tion.    Whence  in  anafarca  the  fluids  in  the  cellular  membrane 

-throughout  the  whole  body  are  abforbed  during  the  ficknefs, 
and  frequently  a  great  quantity  of  atmofpheric  moifture  at  the 
fame  time ;  as  appears  by  the  very  great  difcharge  of  urine, 
which  fometimes  happens  in  thefe  cafes  ;  and  in  ileus  the  pro- 
digious evacuations  by  vomiting,  which  are  often  a  hundred 
fold  greater  than  the  quantity  fwallowed,  evince  the  great  action 
of  all  the  other  abforbents  during  the  ficknefs  of  the  ftomach. 

3.  But  when  the  ftomach  is  rendered  permanently  Cck  by 
an  emetic  drug,  as  by  digitalis,  it  is  not  probable,  that  much  ac- 
cumulation of  fenforial  power  is  foou  produced  in  this  organ  ; 

VOL.  II.  Q  o  o  becauie 


482  THEORY  OF  FEVER.         SUP.  I.  12. 4. 

becaufe  its  ufual  quantity  of  fenforial  power  is  previoufly  ex- 
haufted  by  the  great  ftimulus  of  the  foxglove ;  and  hence  it 
feems  probable,  that  the  great  accumulation  of  fenforial  power, 
which  now  caufes  the  increafed  action  of  the  abforbents,  is  pro- 
duced in  confequence  of  the  inactivity  of  the  heart  and  arteries  ; 
which  inactivity  is  induced  by  deficient  excitement  of  the  fen- 
forial power  of  aflbciation  between  thofe  organs  and-  the  ftom- 
ach,  and  not  by  any  previous  exhauftion  of  their  natural  quan- 
tity of  fenforial  power  ;  whereas  in  ileus,  where  the  torpor  of 
the  ftomach,  and  confequent  ficknefs,  is  induced  by  reverfe 
fympathy  with  an  inflamed  inteftine,  that  is,  by  diflevered  or 
defective  aflbciation  ;  the  accumulation  of  fenforial  power, 
which  in  that  difeafe  fo  violently  actuates  the  cellular,  pulmo- 
nary, and  cutaneous  abforbents,  is  apparently  produced  by  the 
torpor  of  the  ftomach  and  lacteals,  and  the  confequent  accumu- 
lation of  the  fenforial  power  of  aflbciation  in  them  owing  to 
their  leflened  action  in  ficknefs. 

4.  This  accounts  for  the  dry  Ikin  in  fevers  with  weak  pulfe, 
where  the  ftomach  and  the  heart  and  arteries  are  in  a  torpid 
ftate,  and  for  the  fudden  emaciation  of  the  body  j    becaufe  the 
actions  of  the  cellular  and  cutaneous  abforbents  are  increafed 
by  reverfe  fympathy  with  thofe  of  the  ftomach,  or  with  thofe  of 
the  heart  and  arteries  ;  that  is  by  the  expenditure  of  that  fenfo- 
rial power  of  afibciation,  which  is  accumulated  in  confequence 
of  the  torpor  of  the  ftomach  and  heart  and  arteries,  or  of  either 
of  them  5  this  alfo  explains  the  fudden  abforption  of  the  milk  in 
puerperal  fevers  ;  and  contributes  along  with  the  heat  of  the 
refpired  air  to  the  drynefs  of  the   mucous  membrane  of  the 
tongue  and  noftrils.  » 

5.  Befides  the  reverfe  fympathy,  with  which  the  abforbent 
veflels  of  the  ftomach  and  upper  inteftines  act  in  refpect  to  all 
the  ether  abforbent  veflels,  as  in  the  exhibition  of  digitalis,  and 
in  ileus ;  there  is  another  reverfe  fympathy  exifts  between  the 
capillaries,  or  fecretory  veflels  of  the  ftomach,  and  thofe  of  the 
fkin.     Which  may  neverthelefs  be  occafioned  by  the  accumula- 
tion of  fenforial  power  by  the  torpor  of  the  heart  and  arteries, 
which  is  induced  by  direct  fympathy  with  the  ftomach  ;  thus 
when  the  torpor  of  the  ftomach  remains  in  a  fever-fit,  which 
might  otherwife  have  intermitted,  the  torpor  of  the  heart  and 
arteries  remains  alfo  by  direct  fympathy,  and  the  increafed  cu- 
taneous capillary  action,  and  confequent  heat,  are  produced  by 
reverfe  fympathy  5  and  the  fever  is  thus  rendered   continual, 
owing  primarily  to  the  torpor  of  the  ftomach. 

6.  The  reverfe  fympathy,  which  exifts  between  the  capilla- 
ries of  the  ftomach  and  the  cutaneous  capillaries,  appears  by  the 

chillnefs 


SUP.  I.  12.  7.        THEORY  OF  FEVER.  483 

chillnefs  of  feme  people  after  dinner  ;  and  contrariwife  by  the 
digeftion  being  ftrengthened,  when  the  fkin  is  expofed  to  cold 
air  for  a  (hort  time  ;  as  mentioned  in  Clafs  IV.  i.  1.4.  and  IV. 
2.  i.  i.  and  from  the  heat  and  glow  on  the  Ikin,  which  attends 
the  action  of  vomiting  ;  for  though  when  ficknefs  firft  com- 
mences, the  ikin  is  pale  and  cold  ;  as  it  then  partakes  of  the  gen- 
eral torpor,  which  induces  the  ficknefs  ;  yet  after  the  vomiting 
has  continued  fome  minutes,  lo  that  an  accumulation  of  fenfo- 
rial  power  exifts  in  the  capillaries  of  the  ftomach,  and  of  the 
(kin,  owing  to  their  diminifhed  action  ;  a  glow  of  the  (kin  fuc- 
ceeds,  with  fweat>  as  well  as  with  increafed  abforption. 

7.  Neverthelefs  in  fome  circumftances  the  ftomach  and  the 
heart  and  arteries  feem  to  act  by  direct  fympathy  with  the  cu- 
taneous capillaries,  as  in  the  fluihing  of  the  face  and  glow  of  the 
(kin  of  fome  people  after  dinner ;  and  as  in  fevers  with  ftrong 
pulfe.     In  thefe  cafes  there  appears  to  be  an  increafed  produc- 
tion of  fenforial  power,  either  of  fenfation,  as  in  the  blufh  of 
lhame  j  or  of  volition,  as  in  the  blufh  of  anger ;  or  of  irritation, 
as  in  the  flufhed  face  after  dinner  above  mentioned. 

This  increafed  action  of  the  capillaries  of  the  fkin  along  with 
the  increafed  actions  of  the  ftomach  and  heart  is  perhaps  to  be  ef- 
teemed  a  fynchronous  incrafe  of  action,  rather  than  a  fympathy 
between  thofe  organs.  Thus  the  flu(hing  of  the  face  after  din- 
ner may  be  owing  to  the  fecretion  of  fenforial  power  in  the  brain 
being  increafed  by  the  aflbciation  of  that  organ  with  the  ftom- 
ach, in  a  greater  proportion  than  the  increafed  expenditure  of 
it,  or  may  be  owing  alfo  to  the  ilimulus  of  new  chyle  received 
into  the  blood. 

8.  When  the  ftomach  and  the  heart  and  arteries  are  render- 
ed torpid  in  fevers,  not  only  the  cutaneous,  cellular,  and  pulmo- 
nary abforbents  are  excited  to  act  with  greater  energy  5  but  alfo 
their  correfpondent  capillaries  and  fecerning  veflels  or  glands, 
efpecially  perhaps  thofe  of  the  (kin,  are  induced  into  more  ener- 
getic action.     Whence  greater  heat,  a  greater  fecretion  of  per- 
fpirable  matter,  and  of  mucus  ;  and  a  greater  abforption  of  them 
both,  and  of  aerial  moifture.     Thefe  reverfe  fympathies  coin- 
cide with  other  animal  facts,  as  in  eruption  of  fmall-pox  on  the 
face  and  neck  the  feet  become  cold,  while  the  face  and  neck  are 
much  flumed  ;  and  in  the  hemiplegia,  when  one  arm  and  leg  be- 
come difobedient  to  volition,  the  patient  is  perpetually  moving 
the  other.     Which  are  well  accounted  for  by  the  accumulation 
of  fenforial  power  in  one  part  of  an  aflbciated  feries  of  actions, 
when  lefs  of  it  is  expended  by  another  part  of  it ;  and  by  a  defi- 
ciency of  fenforial  power  in  the  fecond  link  of  aflbciation,  when 
too  much  of  it  is  expended  by  the  firft. 

o. 


484  THEORY  OF  FEVER.        SUP.  I.  12.  9. 

9.  This  doctrine  of  reverfe  fympathy  enables  us  to  account 
for  that  difficult  problem,  why  in  continued  fevers  the  increafed 
action  of  the  cutaneous,  cellular,  and  pulmonary  capillaries  pro- 
ceeds without  interruption  or  return  of  cold  fit ;  though  per- 
haps with  fome  exacerbations  and  remiflions  ;  and  that  during 
a  quarter,  or  half,  or  three  quarters,  or  a  whole  lunation  \  while 
at.  the  fame  time  the  pulfations  of  the  heart  and  arteries  are  weak- 
er than  natural. 

To  this  fhould  be  added  the  direct  fympathy,  which  exifts  be- 
tween the  periftaltic  motions  of  the  fibres  of  the  ftomach,  and 
the  pulfations  of  the  heart.  And  that  the  ftomach  has  become 
torpid  by  the  too  great  ftimulus  of  fome  poifonous  or  contagious 
matter  ;  and  this  very  intricate  idea  of  continued  fever  with  fee- 
ble pulfe  is  reduced  to  curious  fimplicity. 

The  direct  fympathy  of  the  ftomach  and  heart  and  arteries 
not  only  appears  from  the  itronger  and  flower  pulfe  of  perfons 
exhaufted  by  fatigue,  after  they  have  drunk  a  glafs  of  wine,  and 
eaten  a  few  mouthfuls  ;  but  appears  alfo  from  the  exhibition  of 
large  dofes  of  digitalis  ;  when  the  patient  labours  under  great 
and  inceffant  efforts  to  vomit,  at  the  fame  time  that  the  actions 
of  the  abforbent  fyftem  are  known  to  be  much  increafed  by  the 
hafty  abforption  of  the  ferous  fluid  in  anafarca,  the  pulfations  of 
the  heart  become  flow  and  intermittent  to  an  alarming  degree. 
See  Clafs  IV.  2.  I.  17.  and  18. 

10.  It  would  aflift  us  much  in  the  knowledge  and  cure  of  fe- 
vers, if  we  could  always  determine,  which  part  of  the  fyftem 
was  primarily  affected  •,  and  whether  the  torpor  of  it  was  from 
previous  excefs  or  defect  of  ftimulus  ;  which  the  induftry  of  fu- 
ture obfervers  muft  difcover.     Thus  if  the  ftomach  be  affected 
primarily,  and  that  by  previous  excefs  of  ftimulus,  as  when  cer- 
tain quantities  of  opium,  or  wine,  or  blue  vitriol,  or  arfenic,  are 
fwallowed,  it  is  fome  time  in  recovering  the  quantity  of  fenforial 
power  previoufly  exhaufted  by  excefs  of  ftimulus,  before  any 
accumulation  of  it  can  occur.     But  if  it  be  affected  with  torpor 
fecondarily,  by  fympathy  with  fome  diftant  part  j  as  with  the 
torpid  capillaries  of  the  {kin,  that  is  by  defective  excitement  of 
the  fenforial  power  of  aflbciation  ;  or  if  it  be  affected  by  defect 
of  ftimulus  of  food  or  of  heat  ;  it  fooner  acquires  fo  much  ac- 
cumulation of  fenforial  power,  as  to  bt  enabled  to  accommodate 
itfelf  to  its  leffened  ftimulus  by  increafe  of  its  irritability. 

Thus  in  the  hemicrania  the  torpor  generally  commences  in  a 
difeafed  tooth,  and  the  membranes  about  the  temple,  and  alfo 
thofe  of  the  ftomach  become  torpid  by  direct  fynchronous  fym- 
pathy ;  and  pain  of  the  head,  and  ficknefs  fupervene ;  but  no 
fever  or  quicknefs  of  pulfe.  In  this  cafe  the  torpor  of  the  ftom- 
ach 


SUP.  I.  12.  10.      THEORY  OF  FEVER. 

ach  is  owing  to  defect  of  the  fenforial  power  of  affociation, 
which  is  caufed  by  the  too  feeble  actions  of  the  membranes  fur- 
rounding  the  difeafed  tooth,  and  thus  the  train  of  fympathy  ceaf- 
cs  here  without  affecting  the  motions  of  the  heart  and  arteries  j 
but  where  contagious  matter  is  fwallowed  into  the  ftomach,  the 
ftomach  after  a  time  becomes  torpid  from  exhauition  of  the  fen- 
forial power  of  irritation,  and  the  heart  and  arteries  act  feebly 
from  defect  of  the  excitement  of  the  power  of  ailuciation.  In 
the  former  cafe  the  torpor  of  the  ftomach  is  conquered  by 
accumulation  of  the  power  of  aflbciation  in  one  or  two  whole 
days  ;  in  the  latter  it  recovers  by  accumulation  of  the  power  of 
irritation  in  three  or  four  weeks. 

In  intermittent  fevers  the  ftomach  is  generally  I  believe  af- 
fected fecondarily  by  fympathy  witli  the  torpid  cutaneous  ca- 
pillaries, or  with  fome  internal  torpid  vifcus,  and  on  this  ac- 
count an  accumulation  of  fenforial  power  arifes  in  a  few  hours 
fufficient  to  reftore  the  natural  irritability  of  this  organ  ;  and 
hence  the  hot  fit  fucceeds,  and  the  fever  intermits.  Or  if  this 
accumulation  of  fenforial  power  becomes  exceffive  and  per- 
manent, the  continued  fever  with  ftrong  pulfe  is  produced,  or 
febris  irritativa. 

In  continued  fevers  the  ftomach  is  frequently  I  fuppofe  af- 
fected with  torpor  by  previous  excefs  of  ftimulus,  and  confe- 
quent  exhauftion  of  fenforial  power,  as  when  contagious  matter 
is  fwallowed  with  the  faliva,  and  it  is  then  much  ilower  in  pro- 
ducing an  accumulation  of  fenforial  power  fufficient  to  reftore  its 
healthy  irritability  ;  which  is  a  frequent  eaufe  of  continued  fe- 
ver with  weak  pulfe  or  febris  inirritativa.  Which  confifts,  after 
the  cold  fit  is  over,  in  a  more  frequent  and  more  feeble  action 
of  the  heart  and  arteries,  owing  to  their  direct  fympathy  with 
the  mufcular  fibres  of  the  torpid  ftomach  ;  together  with  an  in- 
creafed  action  of  the  capillaries,  glands,  and  abforbents  of  the 
ikin,  and  cellulular  membrane,  owing  to  their  reverfe  fympathy 
with  the  torpid  capillaries,  glands,  and  abforbents  of  the  itom- 
aoh,  or  with  thofe  of  the  heart  and  arteries. 

Or  in  more  accurate  language,  i.  The  febris  inirritativa,  or 
fever  with  weak  pulfe,  commences  with  torpor  of  the  ftomach, 
occafioned  by  previous  exhauftion  of  fenforial  power  of  irrita- 
tion by  the  ftimulus  of  contagious  matter  fwallowed  with  the 
faliva.  2.  The  whole  fyftem  becomes  torpid  from  defect  of 
the  excitement  of  the  fenforial  power  of  aflbciation  owing  to 
the  too  feeble  actions  of  the  ftomach,  this  is  the  cold  fit.  -3.  The 
•whole  fyftem,  except  the  ftomach  with  the  upper  intettines,  and 
the  heart  and  arteries,  falls  into  increafed  action,  or  orgafm, 
owing  to  accumulation  of  fenforial  power  of  aflbciation  during 

their 


486  THEORY  OF  FEVER.        Sup.  I.  12. 1 1, 

their  previous  torpor,  this  is  the  hot  fit.  4.  The  ftomach  and 
upper  inteftines  have  not  acquired  their  natural  quantity  of  fen- 
forial  power  of  irritation,  which  was  previoufly  exhaufted  by  vi- 
olent action  in  confequence  of  the  ftimulus  of  contagious 
matter,  and  the  heart  and  arteries  remain  torpid  from  defi- 
cient excitement  of  the  fenforial  power  of  ailbciation,  owing 
to  the  too  feeble  actions  of  the  ftomach.  5.  The  accumulation 
of  fenforial  power  of  afTociation  in  confequence  of  the  torpor  of 
the  heart  and  arteries  occafions  a  perpetual  orgafm,  or  increafed 
action  of  the  capillaries. 

1 1 .  From  hence  it  may  be  deducted  firft,  that  when  the  tor- 
por of  the  ftomach  firft  occurs,  either  as  a  primary  effect,  or  as 
a  fecondary  link  of  fome  afTociate  train  or  circle  of  motions,  a 
general  torpor  of  the  fyftem  fometimes  accompanies  it,  which 
conftitutes  the  cold  fit  of  fever  ;  at  other  times  no  fuch  general 
torpor  occurs,  as  during  the  operation  of  a  weak  emetic,  or  dur- 
ing fea-ficknefs. 

Secondly.  After  a  time  it  generally  happens,  that  a  torpor 
of  the  ftomach  ceafes,  and  its  actions  are  renewed  with  increafe 
of  vigour  by  accumulation  of  fenforial  power  during  its  quief- 
cence  j  as  after  the  operation  of  a  weak  emetic,  or  at  the  inter- 
vals of  fea-ficknefs,  or  after  the  paroxyfm  of  an  intermittent 
fever. 

Thirdly.  The  ftomach  is  fometimes  much  flower  in  recov- 
ering from  a  previous  torpor,  and  is  then  the  remote  caufe  of 
continued  fever  with  weak  pulfe ;  which  is  owing  to  a  torpor 
of  the  heart  and  arteries,  produced  in  confequence  of  the  defi- 
cient excitement  of  the  power  of  aflbciation  by  the  too  weak 
actions  of  the  ftomach  ;  and  to  an  orgafm  of  the  capillaries  of 
the  other  parts  of  the  fyftem,  in  confequence  of  the  accumula- 
tion of  fenforial  power  occafioned  by  the  inactivity  of  the  heart 
and  arteries. 

Fourthly.  The  torpor  of  the  ftomach  is  fometimes  fo  com~ 
plete,  that  probably  the  origin  of  its  nerves  is  likewife  affected, 
and  then  no  accumulation  of  fenforial  power  occurs.  In  this 
cafe,  the  patient  dies  for  want  of  nourimment ;  either  in  three 
or  four  weeks,  of  the  inirritative  fever  ;  or  without  quick  pulfe, 
by  wh,it  we  have  called  parefis  irritativa.  Or  he  continues  ma- 
ny years  in  a  ftate  of  total  debility.  When  this  torpor  fudden- 
ly  commences,  the  patient  generally  fuffers  epileptic  fits  or 
temporary  infanity  from  the  difagreeable  fenfation  of  fo  great  a 
torpor  df  the  ftomach  ;  which  alfo  happens  fometimes  at  the 
eruption  of  the  diftinct  fmall-pox  ;  whence  we  have  termed  this 
difeafe  anorexia  epiieptica.  See  Clafs  II,  2.  2.  I.  and  III.  i.  I. 
7.  and  Suppl.  I.  14.  3. 

Fifthly, 


SUP.  I.  12.  ii.        THEORY  OF  FEVER.  487 

Fifthly.  When  this  torpor  of  the  ftomach  is  lefs  in  degree 
or  extent,  and  yet  without  recovering  its  natural  irritability  by 
accumulation  of  fenforial  power,  as  it  does  after  the  cold  fit 
of  intermittent  fever,  or  after  the  operation  of  mild  emetics,  or 
during  fyncope  j  a  permanent  defect  of  its  activity,  and  of  that 
of  the  upper  mteftines,  remains,  which  conditutes  apepfia,  car- 
dialgia,  hypochondriaiis,  and  hyfteria.  See  Clafs  L  3.  1.3.  and 
I.  2.  4.  5.' 

Sixthly.  If  the  torpor  of  the  ftcmach  be  induced  by  direcl 
fympathy,  as  in  confequence  of  a  previous  torpor  of  the  liver,  or 
fpleen,  or  (kin,  an  accumulation  of  fenforial  power  will  fooner 
be  produced  in  the  ftomach ;  becaufe  there  has  been  no  previ- 
ous expenditure  of  it,  the  prefent  torpor  of  the  ftomach  arifing 
from  defedl  of  aflbciation.  Hence  fome  fevers  perfectly  inter- 
mit, the  ftomach  recovering  its  complete  action  after  the  torpor 
and  confequent  orgafm,  which  conftitute  the  paroxyfm  of  fever, 
are  terminated. 

Seventhly.  If  the  torpor  of  the  ftomach  be  owing  to  defect 
of  irritation,  as  to  the  want  of  food,  an  accumulation  of  fenfo- 
rial power  foon  occurs  with  an  increafe  of  digeftion,  if  food  be 
timely  applied  ;  or  with  violent  inflammation,  if  food  be  given 
in  too  great  quantity  after  very  long  abftinence. 

Eighthly.  If  the  torpor  of  the  ftomach  be  induced  by  defect 
of  pleafurable  ienfation,  as  when  ficknefs  is  caufed  by  the  fug- 
geftion  of  naufeous  ideas ;  an  accumulation  of  fenforial  power 
foon  occurs,  and  the  ficknefs  ceafes  with  the  return  of  hunger , 
for  in  this  cafe  the  inactivity  of  the  ftomach  is  occafioned  by  the 
fubdu£Uon  of  agreeable  fenfation,  which  atls  as  a  fubduClion  of 
ftimulus,  and  not  by  exhaufting  the  natural  quantity  of  fenfori- 
al power  in  the  fibres  or  nerves  of  the  ftomach. 

Ninthly.  If  the  torpor  of  the  ftomach  be  induced  by  a  two* 
fold  caufe,  as  in  fea-ficknefs.  See  vertigo  rotatoria.  Clafs  IV. 
2.  i.  10.  in  which  the  firft  link  of  alfociation  ads  too  ftrongly, 
and  in  confequence  expends  more  than  ufual  of  the  fen  ferial 
power  of  irritation  ;  and  fecondly  in  which  fenfation  is  produc- 
ed between  the  links  of  aflbciation,  and  di'fevers  or  enfeebles 
them  •,  the  accumulation  of  fenforial  power  icon  occurs  in  the 
ftomach  ;  as  no  previous  expenditure  of  it  in  that  organ  has  oc- 
curred. Whence  in  fea-ficknefs  the  perfons  take  food  with  eu- 
gernefs  at  times,  when  the  vertigo  ceafes  for  a  few  minu 

Tenthly.     If  the  gaftric  torpor  be  induced   by  previous  vio- 
lent exertion,  as  after  intoxication,   or  after   contagions  matter 
has  been   fwallowed,  or  fome  poifons,   as  digitalis,  or  an, 
an    accumulatipn    of   fenforial    power    very    ilovvly    fucceeds ; 

wi 


488  THEORY  OF  FEVER.        SUP.  I.  12.  12. 

whence  long  ficknefs,  ar  continued  fever,  becaufe  the  quantity 
of  fenforial  power  already  wafted  miifl  firft  be  renewed,  before 
an  accumulation  of  it  can  be  produced. 

12.  This  leads  us  to  a  fecond  indication  of  cure  in  continued 
fevers,  which  con  fids  in  flrengthening  the  actions  of  the  ftom- 
ach;  as  the  fir  ft  indication  confifted  in  decreafing  the  actions 
of  the  cutaneous  capillaries  and  abforbents.  The  actions  of  the 
iiomachmay  fometimes  be  increafed  by  exhibiting  a  mild  emet- 
ic ;  as  an  accumulation  of  fenforial  power  in  the  fibres  of  the 
ftomach  is  produced  during  their  retrograde  actions.  Befides 
the  evacuation  of  any  noxious  material  from  the  ftomach,  and 
duodenum,  and  from  the  abforbents,  which  open  their  mouths 
on  their  internal  furfaces,  by  their  retrograde  motion. 

It  is  probable,  that  when  mild  eYnetics  are  given,  as  ipecacu- 
anha, or  antimonium  tartarizatum,  or  infufion  of  camomile, 
they  are  rejected  by  an  inverted  motion  of  the  ftomach  and 
cefophfgns  in  confluence  of  difagreeable  fenfation,  as  duft  is 
excluded  from  the  eye  ;  and  thefe  actions  having  by  previous 
habit  been  found  effectual,  and  that  hence  there  is  no  exhauftion 
of  the  fenforial  power  of  irritation.  But  where  ftrong  emetics 
nre  admimftered,  as  digitalis,  or  contagious  matter,  the  previous 
exhauftion  of  the  fenforial  power  of  irritation  feems  to  be  a 
caufe  of  the  continued  retrograde  actions  and  ficknefs  of  the 
ftomach.  An  emetic  of  the  former  kind  may  therefore  ftrength- 
cn  the  power  of  the  ftomach  immediately  after  its  operation  by 
the  accumulation  of  fenforial  power  of  irritation  during  its  ac- 
tion. -See  Clafs  IV.  I.  i. 

Another  method  of  decrenfmg  the  action  of  the  ftomach  for 
a  time,  and  thence  of  increafing  it  afterwards,  is  by  the  accumu- 
lation of  the  fenforial  power  of  irritation  during  its  torpor  ;  is 
by  giving  ice,  iced  water,  iced  creams,  or  iced  wine.  This  ac- 
counts for  the  plenfure,  which  many  people  in  fevers  with  weak 
pulfe  exprefs  on  drinking  cold  beverage  of  any  kind. 

A  fecond  method  of  exciting  the  ftomach  into  action,  and  of 
decreafing  that  of  the  capillaries  in  confequence,  is  by  the  ftimu- 
lus  of  wine,  opium,  bark,  metallic  falts  of  antimony,  fteel,  cop- 
per, arfenic,  given  in  fmall  repeated  quantities  ;  which  fo  long 
r.s  they  render  the  pulfe  flower  are  certainly  of  fervice,  and  may 
be  given  warm  or  cold,  as  moft  agreeable  to  the  patient.  For  it 
is  poflible,  that  the  capillaries  of  the  ftomach  may  act  too  vio- 
lently, and  produce  heat,  at  the  fame  time  that  the  large  mufcles 
of  it  may  be  in  a  torpid  ftate  ;  which  curious  circumftance  future 
obfervations  muft  determine. 

Thirdly.  Hot  fomentation  on  the  region  of  the  ftomach 
might  be  of  moft  effential  fervice  by  its  ftimulus,  as  heat  pene- 
trates 


SUP.  I.  12.  12.        THEORY  OF  FEVER. 

trates  the  fyftem  not  by  the  abforbent  veflels,  but  by  external 
influence  j  whence  the  ufe  of  hot  fomentation  to  the  head  in  tor- 
por of  the  brain  ;  and  the  ufe  of  hot  bath  in  cafes  of  general  de- 
bility, which  has  been  much  too  frequently  neglected  from  a  pop- 
ular error  occafioned  by  the  unmeaning  application  of  the  word 
relaxation  to  animal  power.  If  the  fluid  of  heat  could  be  di- 
rected to  pafs  through  particular  parts  of  the  body  with  as  lit- 
tle diffufion  of  its  influence,  as  that  of  electricity  in  the  (hocks 
from  the  coated  jar,  it  might  be  employed  with  (till  greater  ad- 
vantage. 

Fourthly.  The  ufe  of  repeated  fmall  electric  {hocks  through 
the  region  of  the  ftomach  might  be  of  fervice  in  fevers  with 
weak  pulfe,  and  well  deferves  a  trial ;  twenty  or  thirty  fmall 
{hocks  twice  a  day  for  a  week  or  two  would  be  a  promifmg  ex- 
periment. 

Fifthly.  A  blifter  on  the  back,  or  (ides,  or  on  the  pit  of  the 
ftomach,  repeated  in  fucceflion,  by  ftimulating  the  (kin  frequent- 
ly ftrengthens  the  action  of  the  ftomach  by  exciting  the%fenfo- 
rial  power  of  aflfociation  ;  this  efpecially  in  thofe  'fevers  where 
the  flcin  of  the  extremities,  as  of  the  hands  or  nofe  or  ears,  foori- 
er  becomes  cold,  when  expofed  to  the  air,  than  ufual. 

Sixthly.  The  action  of  the  ftornach  may  be  increafed  by  pre- 
venting too  great  expenditure  of  fenforial  power  in  the  link 
of  previous  motion  with  which  it  is  catenated,  efpecially  if  the 
action  of  that  link  be  greater  than  natural.  Thus  as  the 
capillaries  of  the  (kin  act  too  violently  in  fevers  with  weak 
pulfe,  if  thefe  are  expofed  to  cold  air  or  cold  water,  the  fenfori- 
al power,  which  previoufly  occafioned  their  orgafm,  becomes 
accumulated,  and  tends  to  increafe  the  action  of  the  ftomach  -9 
thus  in  thofe  fevers  with  weak  pulfe  and  hot  (kin,  if  the  ftomach 
be  ftimulated  by  repeated  fmall  dofes  of  bark  and  wine  or  opi- 
um, and  be  further  excited  at  the  fame  time  by  accumulation  of 
fenforial  power  occafioned  by  rendering  the  capillaries  torpid  by 
cold  air  or  water,  this  twofold  application  is  frequently  attende^ 
with  vifible  good  effect. 

By  thus  ftimulating  the  torpid  .ftomach  into  greater  action, 
the  motions  of  the  heart  and  arteries  will  likewife  be  increafed 
by  the  greater  excitement  of  the  power  of  aflbciation.  And  the 
capillaries  of  the  (kin  will  ceafe  to  act  fo  violently,  from  their 
not  pofieffing  fo  great  a  fuperfluity  of  fenforial  power  as  during 
the  greater  quiefcence  of  the  ftomach  and  of  the  heart  and  arte- 
ries. Which  is  in  fome  circumftances  fimilar  to  the  curious 
phenomenon  mentioned  in  Clafs  IV.  2.  2.  10. ;  where,  by  cov- 
ering the  chill  feet  with  flannel  at  the  eruption  of  the  froall-pox, 
the  points  of  the  flannel  ftimulate  the  Jkin  gf  the  feet  into  greater 

VOL.  II.  P  P  p  action/ 


490  THEORY  OF  FEVER.  SUP.  I.  13. 

action,  and  the  quantity  of  heat,  which  they  poifefs,  is  alfo  con- 
fined, or  infulated,  and  further  increafes  by  its  ftimulus  the  ac- 
tivity of  the  cutaneous  veffels  of  the  feet;  and  by  that  circum- 
flance  abates  the  too  great  action  of  the  capillaries  of  the  face, 
and  the  ccnfequent  heat  of  it. 

XIII.   Cafe  of  continued  Fever. 

The  following  cafe  of  continued  fever  which  I  frequently  faw 
during  its  progrefs,  as  it  is  lefs  complicate  than  ufual,  may  il- 
luftrate  this  doctrine.  Matter  S.  D.  an  a£tive  boy  about  eight 
years  of  age,  hadbeerj  in  the  fnow  for  many  days,  and  fat  in  the 
clafiical  fchool  with  wet  feet  \  he  had  alfo  about  a  fortnight  at- 
tended a  writing  fchool,  where  many  children  of  the  lower  or- 
der were  inftru&ed.  He  was  feized  on  February  the  8th,  17951 
with  great  languor,  and  pain  in  his  forehead,  with  vomiting  and 
perpetual  ficknefs  j  his  pulfe  weak,  but  not  very  frequent.  He 
took  an  emetic,  and  on  the  next  day  had  a  blifter,  which  check- 
ed the  ficknefs  only  for  a  few  hours ;  his  Ikin  became  perpetu- 
ally hot,  and  dry  •,  and  his  tongue  white  and  furred  ;  his  pulfc 
when  afleep  about  104  in  a  minute,  and  when  awake  about 
1 12. 

Fourth  day  of  the  difeafe.  He  has  had  another  blifter,  the 
pain  of  his  head  is  gone,  but  the  ficknefs  continues  by  intervals  ; 
he  reftifes  to  take  any  folid  food,  and  will  drink  nothing  but  milk, 
or  milk  and  water,  cold.  He  has  two  or  three  very  liquid  ftools 
every  day,  which  are  fometimes  green,  but  generally  of  a  dark- 
ilh  yellow,  with  great  flatulency  both  upwards  and  downwards 
at  thofe  times.  An  antimonial  powder  was  once  given,  but  in- 
ilantly  rejected  ;  a  fpoonful  of  decoction  of  bark  was  alfo  ex- 
hibited with  the  fame  event.  His  legs  are  bathed,  and  his 
hands  and  face  are  moiftened  twice  a  day  for  half  an  hour  in 
\varmifh  water,  which  is  neverthelcfs  much  colder  than  his 
Ikin. 

Eighfh  day.  His  (kin  continues  hot  and  dry  without  any  ob- 
fervabie  remiffions,  with  liquid  ftools  and  much  flatulency  and 
ficknefs  j  his  water  when  obferved  was  of  a  ftraw  colour.  He 
has  afked  for  cider,  and  drinks  nearly  a  bottle  a  day  mixed 
with  cold  water,  and  takes  three  drops  of  laudanum  twice  a 
day. 

Twelfth  day.  He  continues  much  the  fame,  takes  no  milk, 
drinks  only  cider  and  water,  fkin  hot  and  dry,  tongue  hot  and 
furred,  with  liquid  ftools,  and  licknefs  always  at  the  fame  time  > 
ileeps  much. 

Sixteenth  day.     "Was  apparently  more  torpid,  and  once  rath- 
er 


SUP.  I.  13.  THEORY  OF  FEVER.  49 ' 

er  delirious ;  pulfe  1 12.  Takes  only  capillaire  and  water  ;  fleens 
much. 

Twentieth  day.  Pulfe  100,  fkin  dry  but  lefs  hot,  liquid  ilools 
not  fo  frequent,  he  is  emaciated  to  a  great  degree,  he  has  eaten 
half  a  tea-cup  full  of  cuftard  to  day,  drinks  only  capillaire  and 
•water,  has  thrice  taken  two  large  fpoonfuls  of  deception  of  bark 
with  three  drops  of  laudanum,  r^fufes  to  have  his  legs  bathed, 
and  will  now  take  nothing  but  three  drops  of  laudanum  twice  a 
day. 

Twenty-fourth  day.  He  has  gradually  taken  more  cuftard 
every  day,  and  began  to  attend  to  fome  new  playthings,  and  takes 
wine  fyllabub. 

Twenty-eighth  day.  He  daily  grows  ftronger,  eats  eggs, 
and  bread  and  butter,  and  fleeps  immediately  after  his  food,  can 
creep  on  his  hands  and  knees,  but  cannot  (land  erect. 

Thirty-fecond  day.  He  cannot  yet  Hand  alone  fafely,  but 
feems  hourly  to  improve  in  iirength  of  body,  and  activity  of 
mind. 

In  this  cafe  the  remote  caufe  of  his  fever  could  not  be  well 
afcertained,  as  it  might  be  from  having  his  feet  cold  for  many 
fuccefiive  days,  or  from  contagion  ;  but  the  latter  feems  more 
probable,  becaufe  his  younger  brother  became  ill  of  a  fimilar  fe- 
ver about  three  weeks  afterwards,  and  probably  received  the  in- 
fection from  him.  The  difeafe  commenced  with  great  torpor 
of  the  itomach,  which  was  (hewn  by  his  total  averiion  to  folid 
food,  and  perpetual  ficknefs ;  the  watery  ftools,  which  were 
fometimes  green,  or  of  a  darkifh  yellow,  were  owing  to  the  ac- 
rimony, or  acidity  of  -the  contents  of  the  bowels ;  which  as  well 
as  the  flatulency  were  occahoned  by  indigeition.  This  torpor 
of  the  ilomach  continued  throughout  the  whole  fever,  and  when 
it  ceafed,  the  fever  ceafed  along  with  it. 

The  contagious  material  of  this  fever  I  fuppofe  to  have  been 
mixed  with  the  faliva,  and  fwallo'wed,  into  the  ilomach;  that 
it  excited  the  veflels,  which  conflitute  the  ftomach,  iiuo  the 
greateft  irritative  motion  like  arfenic ;  which  might  not  be  per- 
ceived,  and  yet  might  render  that  organ  paralytic  or  inirrifable  in  a 
moment  of  time  ;  as  animals  fometimcs  die  by  one  fingle  exertion, 
and  confequent  paralyfis,  without  a  fecond  druggie  ;  as  by 
lightning,  or  being  (hot  through  the  back  part  of  the  brain  ;  of 
both  which  I  have  feen  inftances.  I  had  once  an  opportunity 
of  infpecHng  two  oxen,  a  few  minutes  after  they  were  killed  by 
lightning  under  a  crab-tree  on  moid  ground  in  long  grafs  ;  and 
obferved,  that  they  could  not  have  ftruggled,  as  the  grafs  was 
not  prefTcd  or  bent  near  them ;  I  have  alfo  feen  twohorfes  fhot 
through  the  cerebellum,  who  never  once  drew  in  their  legs  after 

they 


THEORY  OF  FEVER.  SUP.  I.  13, 

they  firft  ftretched  them  out,  but  died  inftantaneoufly  ;  in  a  fim- 
ilar  manner  the  lungs  feem  to  be  rendered  inftantly  inanimate 
by  the  fumes  of  burning  fulphur. 

The  lungs  may  be  fometimes  primarily  affeclred  with  conta- 
gious matter  floating  in  the  atmoiphere  as  well  as  the  ftomach, 
as  mentioned  in  article  9.  of  this  Supplement.  But  probably 
this  may  occur  much  lefs  frequently,  becaufe  the  oxygene  of  the 
atmofphere  does  not  appear  to  be  taken  into  the  blood  by  ani-* 
rnal  abforption,  as  the  faliva  in  the  ftomach,  but  pafles  through 
the  moift  membranes  into  the  blood,  like  the  ethereal  fluids  of 
electricity  or  heat,  or  by  chemical  attraction,  and  in  confequence 
the  contagious  matter  may  be  left  behind ;  except  it  may  fome- 
times be  abiorbed  along  with  the  mucus  ;  of  which  however  in 
this  cafe  there  appeared  no  fymptoms. 

The  tonfils  are  other  organs  liable  to  receive  contagious  matter, 
as  in  the  fmall-pox,  fcarlet- fever,  and  in  other  fenfitive  inirritat- 
ed  fevers  ;  but  no  fymptom  of  this  appeared  here,  as  the  tonfils 
were  at  no  time  of  the  fever  inflamed,  though  they  were  in  this 
child  previoufly  uncommonly  large. 

The  pain  of  the  forehead  does  not  feem  to  have  been  of  the 
internal  parts  of  the  head,  becaufe  the  nerves,  which  ferve  the 
ftomach,  are  not  derived  from  the  anterior  part  of  the  brain  ; 
but  it  feems  to  have  been  owing  to  a  torpor  of  the  external  mem- 
branes about  the  forehead  from  their  direct  fympath)*  with  thofe 
of  the  ftomach ;  that  is,  from  the  deficient  excitement  of  the 
fenforial  power  of  aflbciation  ;  and  feemed  in  fome  meafure  to 
be  relieved  by  the  emetics  and  blifters. 

The  pulfations  of  the  heart  were  weaker  and  in  confequence 
quicker  than  natural,  owing  to  their  direct  fympathy  with  the 
torpid  periftaltic  motions  of  the  ftomach ;  that  is  to  the  deficient 
excitement  of  the  fenforial  power  of  aflbciation. 

The  action  of  the  cutaneous  capillaries  and  abforbents  were 
ftronger  than  natural,  as  appeared  by  the  perpetual  heat  and 
dryneis  of  the  {kin  ;  which  was  owing  to  their  reverfe  fympathy 
xvith  the  heart  and  arteries.  This  weaker  and  quicker  action  of 
the  heart  and  arteries,  and  the  ftronger  action  of  the  cutaneous 
capillaries  and  abforbents,  continued  throughout  the  difeafe, 
and  may  be  faid  to  have  conftituted  the  fever,  of  which  the  tor- 
por of  the  ftomach  was  the  remote  caufe. 

His  tongue  was  not  very  much  furred  or  very  dry,  nor  his 
breath  very  hot ;  which  mewed,  that  there  was  no  great  increafe 
of  the  action  of  the  mucous  abforbents,  nor  of  the  pulmonary 
capillaries,  and  yet  fuflieient  to  produce  great  emaciation.  His 
urine  was  nearly  natural  both  in  quantity  and  colour  5  which 

(hewed, 


SUP.  I.  14.  i.        THEORY  OF  FEVER.  49$, 

(hewed,  that  there  was  no  increafe  of  aftion  either  of  the  kid- 
neys, or  of  the  urinary  abforbents. 

The  bathing  his  legs  and  hands  and  face  for  half  an  hour 
twice  a  day  feemed  to  refreih  him,  and  fometimes  made  hi$ 
pulfe  flower,  and  thence  I  fuppofe  ftronger.  This  feems  to 
have  been  caufed  by  the  water,  though  fubtepid,  being  much 
below  the  heat  of  his  (kin,  and  confequently  contributing  to 
cool  the  capillaries,  and  by  fatiating  the  abforbents  to  relieve  the 
uneafy  fenfation  from  the  drynefs  of  the  (kin. 

He  continued  the  ufe  of  three  drops  of  tinclure  of  opium 
from  about  the  eighth  day  to  the  twenty-fourth,  and  for  the 
three  preceding  days  took  along  with  it  two  large  fpoonfuls  of 
an  infufion  of  bark  in  equal  parts  of  wine  and  water.  The  for- 
mer of  thefe  by  its  ftimulus  feemed  to  decreafe  his  languor  for 
a  time,  and  the  latter  to  ftrengthen  his  returning  power  of  di- 
geftion. 

The  daily  exacerbations  or  remiffions  were  obfcure,  and  not 
well  attended  to  ;  but  he  appeared  to  be  worfe  on  the  four- 
teenth or  fifteenth  days,  as  his  pulfe  was  then  quickeft,  and  his 
inattention  greateft  ;  and  he  began  to  get  better  on  the  twen- 
tieth or  twenty-firft  days  of  his  difeafe  ;  for  the  pulfe  then  be- 
came lefs  frequent,  and  his  (kin  cooler,  and  he  took  rather  more 
food  :  thefe  circumftances  feemed  to  obferve  the  quarter  period.* 
of  lunation. 

XIV.   Termination  of  continued  Fever. 

1.  When  the  ftomach  is  primarily  affected  with  torpor  not 
by  defect  of  ftimulus,  but  in  confequence  of  the  previous  ex- 
hauftion  of  its  fenforial  power  ;  and  not  fecondarily  by  its  aflb- 
ciation  with  other  torpid  parts  ;  it  feems  to  be  the  general  caufe 
of  the  weak  pulfations  of  the  heart  and  arteries,  and  the  confe- 
quent  increafed  action  of  the  capillaries,  which  conftitute  con- 
tinued fever  with  weak  pulfe.     In  this  fituation  if  the  patient 
recovers,  it  is  owing  to  the  renovation  of  life  in  the  torpid  ftom- 
ach, as  happens  to  the  whole  fyftem  in  winter-fleeping  animals. 
If  he  perifhes,  it  is  owing  to  the  exhauftion  of  the  body  for 
want  of  nourtmment  occafioned  by  indigeition  ;  which  is  haft- 
ened  by  the  increafed  actions  of  the  capillaries  and  abforbents. 

2,  When  the  ftomach  is  primarily  affected  by  defect  of  ftim- 
ulus, as  by  cold  or  hunger ;  or  fccondavily  by  defect  of  the  pow- 
er of  affociation,  as  in  intermittent  fevers  ;  or  laftly  in  confe- 
quence of  the  introduction  of  the  fenforial  power  of  fenfation, 
as  in  inflammatory  difeafes ;  the  actions  of  the  heart  and  arte- 
ries are  not  diminifhed,  as  when  the  ftomach  is  primarily  af- 
fected 


494  THEORY  OF  FEVER.        SUP.  I.  14.  3. 

fected  with  torpor  by  its  previous  exhauftion  of  fenforial  pow- 
er, but  become  greatly  increafed,  producing  irritative  or  inflam- 
matory fever.  Where  this  fever  is  continued,  though  with 
fome  remiffions  and  exacerbations,  the  exceffive  acltion  is  at 
length  fo  much  leflened  by  expenditure  of  fenforial  power,  as  to 
gradually  terminate  in  health  ;  or  it  becomes  totally  exhaufted, 
and  death  fucceeds  the  destruction  of  the  irritability  and  aflbcia- 
bility  of  the  fyftem. 

3.  There  is  alib  another  termination  of  the  difeafes  in  con- 
fequence  of  great  torpor  of  the  ftomach,  which  are  not  always 
termed  fevers ;  one  of  thefe  is  attended  with  fo  great  and  uni- 
verfal  torpor,  that  the  patient  dies  in  the  firft  cold  fit  ;  that  is, 
within  twelve  hours  or  lefs  of  the  firft  feizure  ;  this  is  common- 
ly termed  fudden  death.     But  the  quicknefs  of  the  pulfe,  and 
the  coldnefs  with  fhuddering,  and  with  fick  ftomach,  diftinguifh- 
cd  a  cafe,  which  I  lately  faw,  from  the  fudden  deaths  occafion- 
ed  by  apoplexy,  or  ruptured  blood-veflels. 

In  hemicrania  I  believe  the  ftomach  is  always  afFe&ed  fec- 
ondarily,  as  no  quicknefs  of  pulfe  generally  attends  it,  and  as 
the  ftomach  recovers  its  activity  in  about  two  whole  days.  But 
in  the  following  cafe,  which  I  faw  laft  week,  I  fuppofe  the 
ftomach  fuddenly  became  paralytic,  and  caufed  in  about  a  week 

the  death  of  the  patient.  Mifs ,  a  fine  young  lady 

about  nineteen,  had  bathed  a  few  times,  about  a  month  before, 
in  a  cold  fpring,  and  was  always  much  indifpofed  after  it  ;  ihe 
was  feized  with  ficknefs,  and  cold  fhuddering,  with  very  quick 
pulfe,  which  was  fucceeded  by  a  violent  hot  fit  ;  during  the 
next  cold  paroxyfm  fhe  had  a  cotavulfion  fit ;  and  after  that 
fyinptoms  of  infanity,  fo  as  to  ftrike  and  bite  the  attendants, 
and  to  fpeak  furious  language  j  the  fame  circumftances  occur- 
red during  a  third  fit,  in  which  I  believe  a  ftrait  waiftcoat  was 
put  on,  and  fome  blood  taken  from  her  ;  during  all  this  time 
her  ftomach  would  receive  no  nutriment,  except  once  or  twice 
a  little  wine  and  water.  On  the  feventh  day  of  the  difeafe, 
when  I  faw  her,  the  extremities  were  cold,  the  pulfe  not  to  be 
counted,  and  (he  was  unable  to  fwallow,  or  to  fpeak  j  a  clyfter 
was  ufed  with  turpentine  and  mufk  and  opium,  with  warm  fo- 
mentations, but  {he  did  not  recover  from  that  cold  fit. 

In  this  cafe  the  convuifion  fit  and  the  infanity  feern  to  have 
been  violent  efforts  to  relieve  the  difagreeable  ienfation  of  the 
paralytic  ftomach ;  and  the  quick  puife,  and  returning  fits  of 
torpor  and  of  orgafm,  evinced  the  difeafe  to  be  attended  with 
fever,  though  it  might  have  been  called  anorexia  maniacalis,  or 
cpileptica. 

4.  Might  not  many  be  faved  in  thefe  fevers  with  weak  pulfe 

for 


SUP.  I.  15.  i.          THEORY  OF  FEVER.  495 

for  a  few  weeks  by  the  introduction  of  blood  into  a  vein,  once 
in  two  or  three  days  ;  which  might  thus  give  further  time  for 
the  recovery  of  the  torpid  ftomach  ?  Which  feems  to  require 
fome  weeks  to  acquire  its  former  habits  of  action,  like  the  muf- 
cles  of  paralytic  patients,  who  have  all  their  habits  of  voluntary 
aflbciations  to  form  afrefh,  as  in  infancy. 

If  this  experiment  be  again  tried  on  the  human  fubject,  it 
fliould  be  fo  contrived,  that  the  blood  in  pafling  from  the  well 
perfon  to  the  fick  one  mould  not  be  expofed  to  the  air  ;  it  mould 
not  be  cooled  or  heated  ;  and  it  mould  be  meafurcd  ;  all  which 
may  be  done  in  the  following  manner.  Procure  two  filver  pipes, 
each  about  an  inch  long,  in  the  form  of  funnels,  wide  at  top, 
with  a  tail  beneatfc,  the  former  fomething  wider  than  a  fwan- 
quill,  and  the  latter  lefs  than  a  fmall  crow-quill.  Fix  one  of 
thefe  filver  funnels  by  its  wide  end  to  one  end  of  the  gut  of  a 
chicken  frefh  killed  about  four  or  fix  inches  long,  and  the  other 
to  the  other  end  of  the  gut  j  then  introduce  the  fmall  end  of" 
one  funnel  into  the  vein  of  the  arm  of  a  well  perfon  downwards 
towards  the  hand  ;  and  laying  the  gut  with  the  other  end  on  a 
water-plate  heated  to  98  degrees  in  a  very  warm  room,  let  the 
blood  run  through  it.  Then  prefling  the  finger  on  the  gut  near 
the  arm  of  the  well  perfon,  flide  it  along  fo  as  to  prefs  out  one 
gutful  into  a  cup,  in  order  to  afcertain  the  quantity  by  weight. 
Then  introduce  the  other  end  of  the  other  funnel  into  a  fimilar 
vein  in  the  arm  of  the  fick  perfon  upwards  towards  the  moul- 
der ;  and  by  fliding  one  finger,  and  then  another  reciprocally, 
along  the  chicken's  gut,  fo  as  to  comprefs  it,  from  the  arm  of 
the  well  perfon  to  the  arm  of  the  fick  one,  the  blood  may  be 
meafured,  and  thus  the  exa6l  quantity  known  which  is  given 
and  received.  See  Clafs  I.  2.  3.  25. 

XV.   Inflammation  excited  in  Fever. 

i .  When  the  actions  of  any  part  of  the  fyftem  of  capillaries 
are  excited  to  a  certain  degree,  fenfation  is  produced,  along 
with  a  greater  quantity  of  heat,  as  mentioned  in  the  fifth  article 
of  this  fupplement.  When  this  increafed  capillary  action  be- 
comes ftili  more  energetic,  by  the  combined  fenforial  powers  of 
fenfation  with  irritation,  new  fibres  are  fecreted,  or  new  fluuis, 
(which  harden  into  fibres  like  the  mucus  fecreted  by  the  iilk- 
worm,  or  fpider,  or  pinna,)  from  which  new  veflels  are  con- 
ftructed  ;  it  is  then  termed  inflammation  :  if  this  exifts  in  the 
capillary  veflels  of  the  cellular  membrane  or  (kin  only,  with  fee- 
ble puliations  of  ^the  heart  and  arteries,  the  febris  fenfmva  inir- 
ritata,  or  malignant  fever,  occurs  ;  if  the  coats  of  the  ai 

are 


THEORY  OF  FEVER.          SUP.  1. 15. 2. 

are  alfo  inflamed,  the  febris  fenfitiva  irritata,  or  inflammatory 
fever,  exifts. 

In  all  thefe  fevers  the  part  inflamed  is  called  a  phlegmon,  and 
by  its  violent  actions  excites  fo  much  pain,  that  is,  fo  much  of 
the  fenforial  power  of  fenfation,  as  to  produce  more  violent  ac- 
tions, and  inflammation,  throughout  the  whole  fyftem.  Whence 
great  heat  from  the  excited  capillaries  of  the  fkin,  large  and 
quick  pulfations  of  the  heart,  full  and  hard  arteries,  with  great 
univerfal  fecretions  and  abforptions.  Thefe  perpetually  con- 
tinue,  though  with  exacerbations  and  remiilions  \  which  feem 
to  be  governed  by  folar  or  lunar  influence. 

2.  In  this  fituation  there  generally,  I  fuppofe,  exifts  an  in- 
creafed  activity  of  the  fecerning  veflels  of  th^  brain,  and  confe- 
quently  an  increafed  production  of  fenforial  jfower ;  in  lefs  vio- 
lent quantity  of  this  difeafe  however  the  increafe  of  the  action 
of  the  heart  and  arteries  may  be  owing  fimply  to  the  accumula- 
tion of  fenforial  power  of  affociation  in  the  ftomach,  when  that 
organ  is  affected  by  fympathy  with  fome  inflamed  part.     In  the 
fame  manner  as  the  capillaries  are  violently  and  permanently  ac- 
tuated by  the  accumulation  of  the  fenforial  power  of  affociation 
in  the  heart  and  arteries,  when  the  ftomach  is  affected  primari- 
ly by  contagious  matter,  and  the  heart  and  arteries  fecondarily. 
Thus  I  fufpect,  that  in  the  diftinct  fmall-pox  the  ftomach  is  af- 
fected  fecondarily  by  fympathy  with  the   infected    tonfils  or 
inoculated  arm  ;  but  that  in  the  confluent  fmall-pox  the  ftom- 
ach is  affected  primarily,  as  well  as  the  tonfils,  by  contagious 
matter  mixed  with  the  faliva,  and  fwallowed. 

3.  In  inflammatory  fevers  with  great  arterial  action,  as  the 
ftomach  is  not  always  affected  with  torpor,  and  as  there  is  a  di- 
rect fympathy  between  the  ftomach  and  heart,  fome  people  have 
believed,  that  naufeating  dofes  of  fome  emetic  drug,  as  of  anti- 
monium  tartarizatum,  have  been  adminiftered  with  advantage, 
abating  by  direct  fympathy  the  actions  of  the  heart.     This  the- 
ory is  not  ill-founded,  and  the  ufe  of  digitalis,  given  in  fmall 
dofes,  as  from  half  a  dram  to  a  dram  of  th£  faturated  tincture, 
two  or  three  times  a  day,  as  well  as  other  lefs  violent  emetic 
drugs,  would  be  worth  the  attention  of  hofpital  phyficians. 

In  three  cafes  of  what  I  believed  to  be  inflammatory  rheu- 
matifm,  two  of  them  attended  with  pain  of  the  fide,  and  diffi- 
cult refpiration,  and  the  other  with  fwelled  joints,  after  repeated 
venefedtions  and  moderate  cathartics,  and  mild  dofes  of  anti- 
monials,  without  fuccefs,  the  tincture  of  digitalis  given  in  the 
fmall  dofe  of  ten  drops  every  fix  hours,  appeared  to  abate  the 
quicknefs  and  hardnefs  of  the  pulfe  in  two  or  three  or  four 
xvithout  inducing  any  degree  of  ftcknefs. 

Sickncfs 


SUP.  I.  15. 4.          THEORY  OF  FEVER.  49) 

Sicknefs  might  alfo  be  produced  probably  with  advantage  by- 
whirling  the  patient  iri  a  chair  fufpended  from  the  ceiling  by 
two  parallel  cords  ;  which  after  being  revolved  fifty  or  a  hun- 
dred times  in  one  direction,  would  return  with  great  circular 
velocity,  and  produce  vertigo,  fimilar  I  fuppofe  to  fea-ficknefs. 
And  laftly  the  ficknefs  produced  by  refpiring  an  atmofphere 
mixed  with  one  tenth  of  carbonated  hydrogen,  difcovered  by- 
Mr.  Watt,  and  published  by  Dr.  Beddoes,  would  be  well  wor- 
thy exact  and  repeated  experiment. 

4.  Cool  air,  cool  fomentations,  or  ablutions,  are  alfo  ufeful 
in  this  inflammatory  fever  ;  as  by  cooling  the  particles  of  blood 
in  the  cutaneous  and  pulmonary  veflels,  they  muft  return  to  the 
heart  with  lefs  ftimulus,  than  when  they  are  heated  above  the 
natural  degree  of  ninety-eight.     For  this  purpofe  fnow  and  ice 
have  been  fcattered  on  the  patients  in  Italy  ;  and  cold  bathing 
has  been  ufed  at  the  eruption  of  the  frnall-pox  in  China,  and 
both,  it  is  faid,  with  advantage.     See  Clafs  III.  2.  i.  12.  and 
Suppl.  I.  8. 

5.  The  lancet  however  with  repeated  mild  cathartics  is  the 
great  agent  in  deftroying  this  enormous  excitement  of  the  fyf- 
tem,  fo  long  as  the  ftrength  of  the  patient  will  admit  of  evacua- 
tions.    Blifters  over  the  painful  part,  where  the  phlegmon  of 
topical  inflammation  is  fituated,  after  great  evacuation,  is  of  ev- 
ident fervice,  as  in  pleurify.     Warm  bathing  for  half  an  hour 
twice  a  day,  when  the  patient  becomes  enfeebled,  is  of  great 
benefit,  as  in  peripneumony  and  rheumatifm. 

6.  When  other  means  fail  of  fuccefs  in  abating  the  violent 
excitement  of  the  fyftem  in  inflammatory  difeafes,  might  not 
the  (haved  head  be  covered  with  large  bladders  of  cold  water,  in 
which  ice  or  fait  had  been  recently  diiTolved  ;  and  changed  as 
often  as  neceflary,  till  the  brain  is  rendered  in  fome  degree  tor- 
pid by  cold  ? — Might  not  a  greater  degree  of  cold,  as  iced  water, 
or  fnow,  be  applied  to  the  cutaneous  capillaries  ? 

7.  Another  experiment  I  have  frequently  wifhed   to  try, 
which  cannot  be  done  in  private  practice,  and  which  I  there- 
fore recommend  to  fome  hofpital  phyfician  ;  and  that  is,  to  en- 
deavour to  ftill  the  violent  actions  of  the  heart  and  arteries,  after 
due  evacuations  by  venefection  and  cathartics,  by  gently  com- 
pre fling  the  brain.     This  might  be  done  by  fufpending  a  bed, 
fo  as  to  whirl  the  patient  round  with  his  head  mod  diftant  from 
the  centre  of  motion,  as  if  he  lay  acrofs  a  mill-done,  as  defcrib- 
cd  in  Sect.  XVIII.  20.     For  this  purpofe  a  perpendicular  (haft 
armed  with  iron  gudgeons  might  have  one  end  pafs   into  the 
floor,  and  the  other  into  a  beam  in  the  ceiling,  with  an  horizon- 
tal arm,  to  which  a  fmall  bed  might  be  readily  fufpended. 

VOL.  ii.  Qj^q  Ey 


498  THEORY  OF  FEVER.         Sup.  I.  id.  i< 

By  thus  whirling  the  patient  with  increafmg  velocity  fleep 
might  be  produced,  and  probably  the  violence  of  the  actions  of 
the  heart  and  arteries  might  be  diminimed  in  inflammatory  fe- 
vers ;  and,  as  it  is  believed,  that  no  accumulation  of  fenforial 
power  would  fucceed  a  torpor  of  the  origin  of  the  nerves,  either 
thus  procured  by  mechanical  compreffion,  or  by  the  bladder- 
cap  of  cold  water  above  defcribed,  the  lives  of  thoufands  might 
probably  be  faved  by  thus  extinguifhing  the  exacerbations  of  fe* 
brile  paroxyfms,  or  preventing  the  returns  of  them. 

Iri  fevers  with  weak  pulfe  fleep,  or  a  degree  of  flupor,  thus 
produced,  might  prevent  the  too  great  expenditure  of  fenforial 
power,  and  thus  contribute  to  preferve  the  patient.  See  Clafs 
I.  2.  5.  10.  on  flupor.  What  might  be  the  confequence  of 
whirling  a  perfon  with  his  head  next  the  centre  of  motion,  fo 
as  to  force  the  blood  from  the  brain  into  the  other  parts  of  the 
body,  might  be  difcovered  by  cautious  experiment  without 
danger,  and  might  probably  add  to  our  ability  of  curing  fever. 

Mr.  Kelly,  in  his  obfervations  on  compreflion,  Edinb.  1797, 
aflerts,  that  by  compreffing  the  two  fubclavian  arteries,  as  they 
pafs  over  the  firft  rib,  more  blood  will  comprefs  the  brain,  and 
produce  a  kind  of  apoplectic  ftate  fimilar  to  that,  which  may 
occur  by  the  centrifugal  force,  if  the  patient  was  whirled  round 
as  above  defcribed.  And  adds,  that  by  this  compreffion  of  the 
two  fubclavian  arteries  a  greater  quantity  of  blood  will  be  cir- 
culated through  the  head,  whence  the  patient  foon  complains  of 
drowfmefs  and  vertigo  ;  and  that  hence  different  fpecies  of 
head-achs  are  foon  removed,  efpeeially  thofe  which  depend  on 
defect  of  ftimulation* 

XVl.  Recapitulation. 

i .  The  fenforial  power  caufes  the  contraction  of  the  fibres* 
and  is  excited  into  action  by  four  different  circumftances,  by  the 
ilimulus  of  external  bodies,  by  pain  or  pleafure,  by  defire  or 
averfion,  or  by  the  previous  motions  of  other  contracting  fibres. 
In  the  firil  fituation  it  is  called  the  fenforial  power  of  irritation, 
in  the  fecond  the  fenforial  power  of  fenfation,  in  the  third  the 
fenforial  power  of  volition,  and  in  the  fourth  the  fenforial  power 
of  aflbciation. 

Many  parts  of  the  body  are  excited  into  perpetual  action,  as 
the  fanguiferous  veflels  confifling  of  the  heart,  arteries,  and 
veins  j  others  into  nearly  perpetual  action,  as  the  conglomerate 
and  capillary  glands  ;  and  others  into  actions  flill  fomewhat 
lefs  frequent,  as  the  alimentary  canal,  and  the  lacteal  and 
lymphatic  abforbents  with  their  conglobate  glands  :  all  thefe  are 

principally 


SI/P.  I.  1 6.  2.        THEORY  OF  FEVER.  499 

principally  actuated  by  the  fenforial  powers  of  irritation,  and  of 
aflbciation  ;  but  in  fome  degree  or  at  fome  times  by  thofe  of 
fenfation,  and  even  of  volition.  There  are  three  kinds  of  ftim- 
ulus,  which  may  eafily  be  occafionally  diminifhed,  that  of  heat 
on  the  fkin,  of  food  in  the  ftomach,  and  of  the  oxygenous  part 
of  the  atmofphere,  which  mixes  with  the  blood  in  refpiration, 
and  ftimulates  the  heart  and  arteries. 

2.  When  any  parts,  which  are  naturally  excited  into  perpetu- 
aj  action  by  ftimulus,  become  torpid  orlefs  active  from  decreafe 
of  that  ftimulus  ;  there  firft  occurs  a  decreafe  of  the  activity  of 
the  parts  next  catenated  with  them  j  thus  going  into  cold  water, 
produces  a  torpor  of  the  capillary  veflels  of  the  lungs,  as  is 
known  by  the  difficult  refpiration,  which  immediately  occurs  ; 
for  the  fenforial  power  of  aflbciation,  which  naturally  contributes 
to  actuate  the  lungs,  is  now  leis  excited  by  the  decreafed  actions 
of  the  cutaneous  veflels,  with  which  they  are  catenated.  This 
conftitutes  the  cold  fit  of  fever. 

There  next  occurs  an  accumulation  of  the  fenforial  power  of 
irritation  in  the  parts,  which  were  torpid  from  defect  of  ftimu- 
lus,  as  the  cutaneous  veflels  for  inftance  when  expofed  to  cold 
air ;  and  a  fimilar  accumulation  of  the  fenforial  power  of  aflbf 
ciation  occurs  in  the  parts  which  were  catenated  with  the  for- 
mer, as  the  veflels  of  the  lungs  in  the  example  above  mentioned. 
Whence,  if  the  fubduction  of  ftimulus  has  not  been  too  great, 
fo  as  to  impair  the  health  of  the  part,  the  activity  of  the  irrita- 
tive motions  returns,  even  though  the  ftimulus  continues  lefs 
than  ufual  ;  and  thofe  of  the  aflbciate  motions  become  confid- 
erably  increafed,  becaufe  thefe  latter  are  now  excited  by  the  pre- 
vious fibrous  motions,  which  now  act  as  ftrong  or  ftronger  than 
formerly,  and  have  alfo  acquired  an  accumulation  of  the  fenfo- 
rial power  of  aflbciation.  This  accounts  for  the  curious  event 
of  our  becoming  warm  in  a  minute  or  two  after  remaining  in 
water  of  about  80  degrees  of  heat,  as  in  the  bath  at  Buxton  •,  or 
in  the  cold  air  of  a  frofty  morning  of  about  30  degrees  of  heat. 

But  if  the  parts  thus  poflefled  of  the  accumulated  fenforial 
powers  of  irritation  and  of  aflbciation  be  expofed  again  to  their 
natural  quantity  of  ftimulus,  a  great  excefs  of  activity  fuper- 
venes  ;  becaufe  the  fibres,  which  poflefs  accumulated  irritation, 
are  now  excited  by  their  ufual  quantity  of  ftimulus  ;  and  thofe 
which  poflefs  accumulated  aflbciation,  are  now  excited  by  double 
or  treble  the  quantity  of  the  preceding  irritative  fibrous  mo- 
tions, with  which  they  are  catenated  ;  this  conftitutes  the  hot 
fit  of  fever. 

Another  important  circumftance  occurs,  when  the  parts, 
which  are  torpid  from  decreafed  ftimulus,  do  not  accumulate  a 

quantity 


500  THEORY  OF  FEVER.        SUP.  I.  16,  3. 

quantity  of  fenforial  power  fufficient  for  the  purpofe  of  renew- 
ing their  own  natural  quantity  of  action  ;  but  are  neverthelefs 
not  fo  torpid,  as  to  have  the  life  of  the  part  impaired.  In  this 
iituation  the  fuperabundance  of  the  accumulated  power  of  irri- 
tation contributes  to  actuate  the  aflbciate  motions  next  catenated 
with  them.  Thus,  when  a  perfon  breathes  air  with  lefs  oxy- 
gene  than  natural,  as  by  covering  his  head  in  bed,  and  thus  re- 
fpiring  the  fame  atmofphere  repeatedly,  the  heart  and  arteries 
become  lefs  active  by  defect  of  the  ftimulus  of  oxygcne  ;  and 
then  the  accumulation  of  fenforial  power  of  irritation  becomes 
initantly  very  great,  as  thefe  urgans  are  fubject  to  perpetual  and 
energetic  action.  This  accumulation  neverthelefs  is  not  fo  great 
as  to  renew  their  own  activity  under  this  defect  of  ftimulus,  but 
yet  is  in  fufficient  abundance  to  increafe  the  aflbciability  of  the 
next  link  of  catenation,  that  is,  to  actuate  the  capillaries  of  the 
fkin  with  great  and  perpetual  increafe  of  energy.  This  refem- 
bles  continued  fever  with  weak  pulfe  ;  in  which  the  accumula- 
tion of  the  fenforial  power  caufed  by  the  leflened  motions  of  the 
heart  and  arteries,  actuates  the  capillaries  with  increafe  of  energy. 
3.  When  the  accumulation  of  the  feniorial  power  of  aflbci- 
ation, which  is  caufed  as  above  explained  by  deficient  excite- 
ment owing  to  the  leflened  quantity  of  action  of  the  irritative 
fibrous  motions,  with  which  the  aflbciate  train  is  catenated,  is 
not  in  quantity  fufficient  to  renew  the  natural  actions  of  the  firft 
link  of  an  aflbciate  train  of  motions  •,  it  is  neverthelefs  fre- 
quently fo  abundant  as  to  actuate  the  next  link  of  the  aflbciated 
train  with  unnatural  energy  by  increafing  its  aflbciability  ;  and 
that  in  a  ftill  greater  degree  if  that  fecond  link  of  the  aflbciated 
train  was  previously  in  a  torpid  ftate,  that  is,  had  previously  ac- 
quired fome  accumulation  of  the  fenforial  power  of  aflbciation. 
This  important  circumftance  of  the  animal  economy  is  worthy 
our  moft  accurate  attention.  Thus  if  the  heart  and  arteries  are 
deprived  of  their  due  quantity  of  the  ftimulus  of  oxygene  in  the 
blood,  a  weak  and  quick  pulfe  enfues,  with  an  accumulation  of 
the  fenforial  power  of  ir/itation  ;  next  follows  an  increafe  of  the 
action  of  the  capillaries  by  the  fuperabundance  of  this  accumu- 
lated power  of  irritation  ;  but  there  alfo  exifts  an  accumulation 
of  the  power  of  aflbciation  in  thefe  acting  capillaries,  which  is 
not  now  excited  by  the  deficient  actions  of  the  heart  and  arte- 
ries ;  but  which  by  its  abundance  contributes  to  actuate  the 
next  link  of  aflbciation,  which  is  the  fick  ftomach  in  the  cafe 
related  from  Sydenham  in  Clafs  IV.  i.  i.  2.  and  explained  in 
this  Supplement  I.  4.  And  as  this  fick  ftomach  was  in  a  pre- 
vious ftate  of  torpor,  it  might  at  the  fame  time  poflefs  an  accu- 
mulation of  fome  fenforial  power,  which,  if  it  was  of  aflbciation, 

would 


SUP.  I.  1 6. 4.          THEORY  OF  FEVER.  501 

would  be  thus  more  powerfully  excited  by  the  increafcd  actions 
of  the  capillaries ;  which  exifted  in  confequence  of  the  weak 
action  of  the  heart  and  arteries.  This  alfo  refembles  in  fomc 
rcfpects  the  continued  fevers  with  weak  pulfe,  and  with  increaf- 
cd activity  of  the  capillaries. 

4  4.  When  a  torpor  of  fome  irritative  motions  occurs  from  a 
previous  exhauftion  of  the  fenforial  power  of  irritation  by  the 
action  of  fome  very  great  ftimulus,  it  is  long  before  any  accu- 
mulation of  the  fenforial  power  of  irritation  is  produced  ;  as  is 
experienced  in  the  ficknefs  and  languor,  which  continues  a  whole 
day  after  a  fit  of  drunken nefs.  But  nevertheless  there  occurs 
an  accumulation  of  the  fenforial  power  of  aflbciation  in  the  firft 
link  of  the  aflbciate  train  of  motions,  which  is  catenated  with 
thefe  torpid  irritative  ones  ;  which  accumulation  is  owing  to  de- 
ficient excitement  of  that  fenforial  power  in  the  firft  link  of  the 
aflbciate  train.  This  firft  link  therefore  exifts  alfo  in  a  lefs  ac- 
tive or  torpid  ftate,  but  the  accumulation  of  the  fenforial  power 
of  aflbciation  by  its  fuperabundance  contributes  to  actuate  the 
fecond  link  of  the  aflbciate  train  with  unnatural  quantity  of  mo- 
tion ;  and  that  though  its  own  natural  quantity  of  the  power 
of  aflbciation  is  not  excited  by  the  deficient  action  of  preceding 
fibrous  motions. 

When  this  happens  to  the  ftomach,  as  after  its  irritative  mo- 
tions have  been  much  exerted  from  the  unnatural  ftimulus  of 
wine,  or  opium,  or  of  contagious  matter  mixed  with  the  faliva, 
a  torpor  or  inactivity  of  it  fucceeds  for  a  greater  or  lefs  length 
of  time  ;  as  no  accumulation  of  the  fenforial  power  of  irritation 
can  occur,  till  the  natural  quantity,  which  has  been  previoufly  ex- 
pended, is  firft  reftored.  Then  the  heart  and  arteries,  which  are 
next  in  catenation,  become  lefs  active  from  the  want  of  fuffi- 
cient  excitement  of  the  fenforial  power  of  aflbciation,  which 
previoufly  contributed  to  actuate  them.  This  fenforial  power 
of  aflbciation  therefore  becomes  accumulated,  and  by  its  fuper- 
abundance contributes  to  actuate  the  link  next  in  aflbciation, 
which  has  thus  acquired  fo  great  a  degree  of  aflbciability,  as  to 
overbalance  the  lefs  quantity  of  the  excitement  of  it  by  the  tor- 
pid action  of  the  previous  or  firft  aflbciate  link.  This  happens 
to  the  capillaries,  when  the  heart  and  arteries  are  affected  as 
above  by  the  torpor  of  the  ftomach,  when  it  is  occafioned  by 
previous  great  expenditure  of  its  fenforial  power,  and  thus  con- 
ftitutes  fever  with  weak  pulfe,  which  is  here  termed  ininitative 
fever,,  typhus  mitior. 

5.  When  a  deficiency  of  ftimulus  is  too  great  or  too  long  con- 
tinued, fo  as  to  impair  the  life  of  the  part,  no  further  accumu- 
lation of  fenforial  power  occurs  j  as  when  the  fkin  is  long  ex- 

poi>d 


THEORY  OF  FEVER.        SUP.  I.  16.  6, 

pofed  to  cold  and  damp  air.  In  that  cafe  the  link  in  catenation, 
that  is,  the  firft  of  the  aflbciate  train,  is  rendered  torpid  by  de- 
fect of  excitement  of  its  ufual  quantity  of  the  fenforial  power  of 
ailbciation,  and  from  there  being  no  accumulation  of  the  fenfori- 
al power  of  irritation  to  increafe  its  aflbciability,  and  thus  to  con- 
tribute to  actuate  it  by  overbalancing  the  defect  of  the  excite- 
ment of  its  aflbciation. 

Thus  on  riding  long  and  ilowly  on  a  cold  and  damp  day, 
the  exhalation  of  the  vapour,  which  is  impinged  on  the  fkin,  as 
the  traveller  proceeds,  carries  away  his  warmth  fafter,  than  it  is 
generated  within  the  fyftem  ;  and  thus  the  capillaries  of  the  fkin 
have  their  actions  fo  much  impaired  after  a  time,  that  no  accu- 
mulation of  the  fenforial  power  of  irritation  occurs  ;  and  then 
the  ftomach,  the  motions  of  which  are  catenated  with  thofe  of 
the  capillaries,  ceafes  to  aft  from  the  deficient  excitement  of  the 
power  of  aflbciation  •,  and  indigeftion  and  flatulency  fucceed, 
inflead  of  the  increafed  digeftion  and  hunger,  which  occur, 
when  the  cutaneous  capillaries  are  expofed  to  a  lefs  degree  of 
cold,  and  for  a  fhorter  time.  In  which  latter  fitwation  the  accu- 
mulation of  the  fenforial  power  of  irritation  increafes  by  its  fu- 
perabundance  the  aflboiability  of  the  fibres  of  the  ftomach,  fo 
as  to  overbalance  the  defeat  of  the  excitement  of  their  aflbcia- 
tion. 

6.  The  ftomach  is  affected  fecondarily  in  fevers  with  ftrong 
pulfe,  as  in  thofe  with  weak  pulfe  it  is  affected  primarily.  To 
illuftrate  this  doctrine  I  fhall  relate  the  following  cafe  of  Mr. 

Y- • — .  He  was  a  young  man  rather  intemperate  in  the  ufe 

of  wine  or  beer,  and  was  feized  with  a  cold  fit,  and  with  a  con- 
fequent  hot  one  with  ftroug  pulfe  •,  on  examining  his  hypochon- 
drium  an  oblong  tumour  was  diftinctly  felt  on  the  left  fide  of 
the  ftomach,  which  extended  fix  or  eight  inches  downward,  and 
was  believed  to  be  a  tumour  of  the  fpleen,  which  thus  occafioned 
by  its  torpor  the  cold  fit  and  confequent  hot  fit  of  fever  with 
ftrong  pulfe.  This  fever  continued,  though  with  remiflions, 
for  two  or  three  weeks  ;  and  the  patient  repeatedly  loft  blood, 
ufetl  cathartics  with  calomel  and  fenna,and  had  frequent  antimo- 
nial  and  faline  medicines.  And  after  he  was  much  weakened 
by  evacuations,  '(the  peruvian  bark  and  fmall  dofes  of  fteel  re- 
moved the  fever,  but  the  tumour  remained  many  years  during 
the  remainder  of  his  life. 

In  this  cafe  the  tumour  of  the  fpleen  was  occafioned  by  the 
torpor  of  the  abforbent  veflels ;  while  the  fecerning  veflels  con- 
tinued fomewhat  longer  to  pour  their  fluids  into  the  cells  of  it. 
Then  the  inactivity  of  this  vifcus  affected  the  whole  fyftem  with 
torpor  by  the  deficient  excitement  of  the  fenforial  power  of  aflb-r 

ciation, 


SUP.  I.  16. 6.        THEORY  OF  FEVER,  503 

elation,  which  contributes  along  with  the  irritation  caufcd  by 
their  fpecific  ftimuli  to  actuate  the  whole  fanguiferous,  fecem-* 
ing,  and  abforbent  veflels ;  and  along  with  thei'e  the  ftomach, 
which  poflefles  perhaps  greater  mobility,  or  promptitude  co  tor- 
por or  to  orgafm,  than  any  other  part.  And  after  a  time  all  thelc 
parts  recover  their  actions  by  the  accumulation  of  their  fenfori- 
al  power  of  affociation.  But  the  fpleen  not  recovering  its  ac- 
tion from  the  accumulation  of  its  power  of  irritation,  as  appear- 
ed from  the  continuance  of  the  tumour,  (till  affects  the  ftomach 
by  its  defective  irritative  motions  ceafmg  to  excite  the  affocia* 
tion,  which  ought  to  contribute  to  actuate  it. 

Hence  the  ftomach  continues  torpid  in  refpect  to  its  motions, 
but  accumulates  its  power  of  aflbciation  5  which  is  not  excited 
into  action  by  the  defective  motions  of  the  fpleen ;  this  accu- 
mulation of  the  fenforial  power  of  ailbciation  now  by  its  fuper- 
abundance  actuates  the  next  link  of  affociate  motions,  which 
confifts  of  the  heart  and  arteries,  into  greater  energy  of  action 
than  natural,  and  thus  caufes  fever  with  ftrong  pulie  j  which, 
as  it  was  fuppofed  to  be  uioft  frequently  excited  by  increafe  of 
irritation,  is  called  irritative  fever  or  fynocha. 

Similar  to  this  in  the  fmall-pox,  which  is  given  by  inocula- 
tion, the  ftomach  is  affected  fecondarily,  when  the  fever  com- 
mences $  and  hence  in  this  fmall-pox  the  pulfations  of  the  heart 
and  arteries  are  frequently  ftronger  than  natural,  but  never 
weaker,  for  the  reafons  above  given.  Whereas  in  that  fmall-pox, 
which  is  caufed  by  the  ftomach  being  primarily  affected,  by  the 
contagious  matter  being  fwallowed  with  die  faliva,  whether  the 
tonfils  are  at  the  fame  time  affected  or  not,  the  pulfations  of  the 
heart  and  arteries  become  weak,  and  the  inirritative  fever  is 
produced,  as  explained  above,  along  with  the  confluent  fmall- 
pox.  This  unfolds  the  caufe  of  the  mildnefs  of  the  inoculated 
fmall-pox  5  becaufe  in  this  difeafe  the  ftomach  is  affected  fecond- 
arily, whereas  in  the  natural  fmall-pox  it  is  frequently  affect* 
ed  primarily  by  fwallowing  the  contagious  matter  mixed  with 
faliva. 

In  the  meafles  I  fuppofe  the  contagious  matter  to  be  diffolved 
in  the  air,  and  therefore  not  liable  to  be  mixed  with  the  faliva  ; 
whereas  the  variolous  matter  is  probably  only  diffufed  in  the  air, 
and  thence  more  readily  mixed  with  the  faliva  in  the  mouth  dur- 
ing refpiration.  This  difference  appears  more  probable,  as  the 
fmali-pox  I  believe  is  always  taken  at  a  lefs  diftance  from  the 
difeafed  perfon  than  is  neceffary  to  acquire  the  mealies.  The 
contagion  of  the  meafles  affects  the  membranes  of  the  noftriis, 
and  the  fecretion  of  tears  in  confequence,  but  never  I  fuipect 
flora  ach  primarily,  but  always  fecondarily  ;  whence  the  pui- 


5o4  THEORY  OF  FEVER.         SUP.  I.  16.  ?, 

fation  of  the  heart  and  arteries  is  always  ftronger  Ujan  natural, 
fo  as  to  bear  the  lancet  at  any  period  of  the  difeafe. 

The  great  mildnefs  fometimes,  and  fatality  at  other  times,  of 
the  fcaflet  fever  may  depend  on  the  fame  circumftance  ;  that  is, 
on  the  ftomach  being  primarily  or  fecondarily  affected  by  the 
contagious  matter,  obferving  that  the  tonfils  may  be  affected  at 
the  fame  time  with  the  ftomach.  Should  this  prove  to  be  the 
cafe,  which  future  obfervations  muft  determine,  what  certain  ad- 
vantage muft  arife  from  the  inoculation  of  this  difeafe  !  When 
it  is  received  by  the  fkin  primarily  I  fuppofe  no  fore  throat  at- 
tends it,  nor  fever  with  weak  pulfe  ;  when  it  is  received  by  the 
ftomach  primarily,  the  tonfils  are  affected  at  the  fame  time,  and 
the  torpor  of  the  ftomach  produces  inirritative  fever,  and  the 
mortification  of  the  tonfils  fucceeds. 

We  may  hence  conclude,  that  when  the  torpor  of  the  ftom- 
ach is  either  owing  to  defect  of  ftimulus,  which  is  not  fo  great 
as  to  impair  the  life  of  the  part,  as  in  moderate  hunger,  or  in 
fwallowing  iced  water,  or  when  its  torpor  is  induced  by  its  cat- 
enation or  aflbciation  with  other  torpid  parts,  as  in  the  com- 
mencement of  intermittent  fevers,  and  inoculated  fmall-pox,  that 
the  fubfequent  action  of  the  heart  and  arteries  is  generally  in- 
creafed,  producing  irritative  fever.  Which  is  owing  to  the  ac* 
cumulation  of  the  fenforial  power  «of  irritation  in  one  cafe,  and 
of  affociation  in  the  other,  contributing  to  actuate  the  next  link 
of  the  catenated  or  aflbciated  motions.  But  when  the  torpor  of 
the  ftomach  is  induced  by  previous  exhauftion  of  its  fenforial 
powers  of  irritation  or  of  aflbciation  by  continued  violent  action, 
as  by  the  ftimulus  of  digitalis,  or  of  contagious  matter,  or  after 
intoxication  from  wine  or  opium,  a  weaker  action  of  the  heart 
and  arteries  fucceeds,  becaufe  there  is  no  accumulation  of  fen* 
forial  power,  and  a  deficient  excitement  of  aflbciation.  And 
finally,  as  this  weak  action  of  the  heart  and  arteries  is  not  in- 
duced by  exhauftion  of  fenforial  power,  but  by  defect  of  the  ex* 
citement  of  aflbciation,  the  accumulation  of  this  power  of  aflb- 
ciation increafes  the  action  of  the  capillaries,  and  thus  induces 
inirritative  fever. 

7.  When  any  part  of  the  fyftem  acts  very  violently  in  fevers, 
the  fenforial  power  of  fenfation  is  excited,  which  increafes  the 
actions  of  the  moving  fyftem  :  whereas  the  pain,  which  arifes 
from  decreafed  irritative  motions,  as  in  hemicrania,  feems  to  ex- 
hauft  a  quantity  of  fenforial  power,  without  producing  or  in- 
creafing  any  fibrous  actions. 

When  the  ftomach  is  primarily  affected, as  in  inirritative  fevers 
from  contagion,  and  in  fuch  a  manner  as  to  occafion  pain,  the 
ailion  of  the  capillaries  feems  to  be  increafed  by  this  additional 

fenforial 


SUP.  I.  1 6.  7.        THEORY  OF  FEVER.  505 

fenforial  power  of  fenfation,  whence  extenfive  inflammation  or 
mortification  •,  but  when  the  ftomach  and  confequently  the  heart 
•and  arteries  continue  their  torpidity  of  action  ;  as  in  confluent 
fmall-pox,  and  fatal  fcarlatina  j  this  constitutes  fenfitive  inirri* 
tative  fever,  or  typhus  gravior. 

But  when  the  ftomach  is  fecondarily  affected,  if  the  fenforial 
power  of  fenfation  is  excited,  as  in  pleurify  or  peripneurnony* 
the  actions  of  the  heart  and  arteries  are  violently  increafed,  and 
of  all  the  moving  fyftem  along  with  them.  Thus  the  peripneu- 
mony  is  generally  induced  by  the  patient  refpiring  very  cold  air, 
and  this  efpecially  after  being  long  confined  to  warm  air,  or  af- 
ter being  much  fatigued  and  heated  by  exceflive  labour  or  exer- 
cife.  For  we  can  cover  the  fkin  with  more  clothes,  when  we 
feel  ourfelves  cold  ;  but  the  lungs  not  having  the  perception  of 
cold,  we  do  not  think  of  covering  them,  nor  have  the  power  to 
cover  them,  if  we  defired  it ;  and  the  torpor  thus  produced  is 
greater,  or  of  longer  duration,  in  proportion  to  the  previous  ex- 
penditure of  fenforial  power  by  heat  or  exercife* 

This  torpor  of  the  lungs  affects  the  (kin  with  fhuddering,  and 
the  ftomach  is  alfo  fecondarily  affe&ed  ;  next  follows  the  violent 
action  of  the  lungs  from  the  accumulation  of  the  power  of  irri- 
tation, and  an  inflammation  of  them  follows  this  violent  action. 
While  the  ftomach  recovers  its  activity  by  the  increafe  of  the 
excitement  of  the  fenibrial  power  of  aflbciation,  and  along  with 
it  the  heart  and  arteries,  and  the  whole  moving  fyftem.  Hence 
this  inflammation  occurs  during  the  hot  fit  of  fever,  and  no  cold 
fit  fucceeds,  becaufe  the  excefs  of  the  fenforial  power  of  fenfa- 
tion prevents  a  fucceeding  torpor. 

Thefe  new  motions  of  certain  parts  of  the  fyftem  produce  in- 
creafed fecretions  of  nutritious  or  organic  mucus,  which  forms 
new  veiTels ;  thefe  new  veffels  by  their  unufual  motions  produce 
new  kinds  of  fluids  ;  which  are  termed  contagious,  becaufe  they 
have  the  power,  when  introduced  into  a  healthy  body,  of  pro* 
ducing  (iriilar  actions  and  effects,  with  or  without  fever,  as  in 
the  fmall-pox  and  meafles,  or  in  the  itch  and  venereal  difeafe. 

If  any  of  thefe  contagious  matters  affect  the  ftomach  with  tor- 
por either  by  their  ftimulus  immediately  applied,  or  by  its  fym- 
:  parts  fir  ft  di  Tea  led,  a  fever  is  produced  with  fick- 
;  of  appetite  ;  as  in  fmall-pox,  and  fcarlatina.     If 
the  itomach  is  not  affected  by  contagious  matter,  no  fever  fuo 
ceeds,  as  in  itch,  tinea,  fyphilis. 

All  thefe  contagious  matters  are  conceived  to  be  harmlefs,  till 

they  have  been  expofed  to  the  air,  either  openly  or  through  a 

&         membrane  ;  from  which  they  are  believed  to  acquire  oxy- 

g         rtiid  thence  to  become  fome  kinds  of  animal  acids.     As 

H.  R  R  r  the 


506  THEORY  OF  FEVER.          SUP.  I.  16. 8. 

the  preparations  of  mercury  cure  venereal  ulcers  ;  as  a  quarter 
of  a  grain  of  fublimate  diflblved  in  wine,  and  given  thrice  a 
day  ;  this  effect  feems  to  be  produced  either  by  its  ftimulating 
the  abforbents  in  the  ulcer  to  abforb  the  venereal  matter  before 
it  has  acquired  oxygene  ;  or  by  afterwards  uniting  with  it  chem- 
ically, and  again  depriving  it  of  its  acquired  acidity.  On  either 
fuppofition  it  might  probably  be  given  with  advantage  in  fmail- 
pox,  and  in  all  infectious  difeafes,  both  previous  to  their  com- 
mencement, and  during  their  whole  progrefs. 

8.  The  cold  fits  of  intermittent  fevers  are  caufed  by  the  tor- 
por of  fome  part  owing  to  deficient  irritation,  and  of  the  other 
parts  of  the  fyftem  from  deficient  afibciation.  The  hot  fits  are 
owing  firft  to  the  accumulation  of  irritation  in  the  part  prima- 
rily affected,  if  it  recovers  its  action,  which  does  not  always  hap- 
pen ;  and  fecondly  to  the  accumulation  of  aflbciation  in  the  oth- 
er parts  of  the  fyitem,  which  during  health  are  fubjedt  to  per- 
petual action ;  and  laftly  alfo  to  the  greater  excitement  of  the 
power  of  affociation,  when  the  part  primarily  affected  recovers 
its  irritability,  and  acts  with  greater  energy  than  natural. 

The  deficient  fecretions  in  the  cold  fit  depend  on  the  torpor 
of  the  glandular  fyftem  ;  and  the  increafed  fecretions  in  the  hot 
fit  on  their  more  energetic  action.  The  thirft  in  the  cold  fit  is 
owing  to  the  deficient  abforptioa  from  the  (kin,  cellular  mem- 
brane, and  bladder  j  the  thirft  in  the  hot  fit  is  owing  to  the  too 
great  diffipation  of  the  aqueous  part  of  the  blood.  The  urine 
is  pale  and  in  fmall  quantity  in  the  cold  fit  from  deficient  fecre- 
tion  of  it,  and  from  deficient  abforption  of  its  aqueous  parts  ;  it 
is  high  coloured,  and  fometimes  depofits  a  fediment,  in  the  hot 
fit  from  the  greater  fecretion  of  it  in  the  kidneys,  and  the  great- 
er abforption  of  its  aqueous  and  faline  part  in  the  bladder.  The 
drynefs  and  fcurf  on  the  tongue  arid  noftrils  are  owing  to  the 
increafed  heat  of  the  air  expired  from  the  lungs,  and  confequent 
greater  evaporation  of  the  aqueous  part  of  the  mucus.  The 
fweats  appear  in  confequence  of  the  declenfion  of  the  hot  fit, 
owing  to  the  abforbent  veffels  of  the  fkin  lofing  their  increafed 
action  fooner  than  the  fecerning  ones  •,  and  to  the  evaporation 
leffening  as  the  fkin  becomes  colder.  The  returns  of  the  par- 
oxyfms  are  principally  owing  to  the  torpor  of  fome  lefs  effential 
part  of  the  fyftem  remaining  after  the  termination  of  the  laft  fit ; 
and  are  alfo  dependent  on  folar  or  lunar  diurnal  periods. 

The  torpor  of  the  part,  which  induces  the  cold  paroxyfm,  is 
owing  to  deficient  irritation  occafioned  either  by  the  fubduction 
of  the  natural  ftimuli  of  food,  or  water,  or  pure  air,  or  by  de- 
ficiency of  external  influences,  as  of  heat,  or  of  folar  or  lunar 
gravitation.  Or  fecondly,  in  confequence  of  the  exhauftion  of 

fenforia! 


SUP.  I.  16. 9.          THEORY  OF  FEVER.  507; 

fenforial  power  by  great  previous  exertions  of  fome  parts  of  the 
fyftem,  as  of  the  limbs  by  great  labour  or  exercife,  or  of  the 
flomach  by  great  ftimulus,  as  by  contagious  matter  fwallowed 
•with  the  faliva,  or  by  much  wine  or  opium  previoufly  taken  into 
it.  Or  laftly  a  torpor  of  a  part  may  be  occafioned  by  fome  me- 
chanic injury,  as  by  a  compreflion  of  the  nerves  of  the  part,  or 
of  their  origin  in  the  brain  ;  as  the  fitting  long  with  one  leg 
crofled  over  the  other  occafions  numbnefs,  and  as  a  torpor  of- 
the  flomach  with  vomiting  frequently  precedes  paralytic  itrokes 
of  the  limbs. 

As  ileep  is  produced,  either  by  defect  of  ftimulus,  or  by  pre- 
vious exhauftion  of  fenforial  power ;  fo  the  accumulation  of  the 
fenforial  power  of  volition  in  thofe  mufcles  and  organs  of  fenfe, 
which  are  generally  obedient  to  it,  awakens  the  fleeping  perfon  j 
when  it  has  increased  the  quantity  of  voluntarily  fo  much  as  to 
overbalance  the  defect  of  ftimulus  in  one  cafe,  and  the  exhauf- 
tion of  fenforial  power  in  the  other ;  which  latter  requires  a 
much  longer  time  of  fleep  than  the  former.  So  the  cold  par- 
oxyfm  of  fever  is  produced  either  by  defect  of  ftimulus,  or  by 
previous  exhauftion  of  the  fenforial  power  of  fome  part  of  the 
fyftem  ;  and  the  accumulation  of  the  fenforial  power  of  irrita- 
tion in  that  part  renews  the  action  of  it,  when  it  has  increafed 
its  irritability  fo.much  as  to  overbalance  the  defect  of  ftimulus  in 
one  cafe,  and  the  exhauftion  of  fenforial  power  in  the  other  ; 
which  latter  requires  a  much  longer  torpor  or  cold  fit  than  the 
former. 

But  in  the  cold  paroxyfm  of  fever,  befides  the  torpor  of  one 
part  of  the  fyftem  from  defect  of  irritation,  the  remainder  of  it 
becomes  torpid  owing  to  defect  of  excitement  of  the  fenforial 
power  of  aiTociation  by  the  leflened  action  of  the  part  firit  affect- 
ed. This  torpor  of  the  general  fyftem  remains,  till  the  accumu- 
lation of  the  fenforial  power  of  aflbciation  has  increafed  the  af- 
fociability  fo  much  as  to  overbalance  the  defect  of  the  ex- 
citement of  aflbciation ;  then  the  torpor  ceafes,  and  if  the  firft 
affected  part  has  recovered  its  activity,  the  other  parts  are  all 
thrown  into  excefs  of  action  by  their  increafed  afTociability,  and 
the  hot  fit  of  fever  is  produced. 

9.  In  the  continued  fevers  with  ftrong  pulfe  the  ftomach  is 
affected  fecondarily,  and  thus  acts  feebly  from  deficient  excite- 
ment of  the  power  of  aflbciation  ;  but  the  accumulation  of  the 
power  of  aflbciation  thus  produced  in  an  organ  fubject  to  per- 
petual and  energetic  action,  is  fo  great  as  to  affect  the  next  link 
of  the  aflbciate  train,  which  confifts  of  the  heart  and  arteries  ; 
thefe  therefore  are  exerted  perpetually  with  increafe  of  action. 

In  continued  fevers  with  weak  pulfe  the  torpid  ftomach  is  af- 
fected 


THEORY  OF  FEVER.        SUP.  I.  16.  9. 

fe£led  primarily  by  previous  exhauftion  of  its  irritability  by  ftim- 
ulus,  as  of  contagious  matter  fwallowed  into  it.  The  heart  and 
arteries  a£l  feebly  from  deficient  excitement  of  the  power  of 
aflbciation,  owing  to  the  torpor  of  the  ftomach,  with  which  they 
are  catenated  ;  but  the  accumulation  of  the  power  of  aflbciation, 
thus  produced  in  organs  fubjecl:  to  perpetual  and  energetic  mo- 
tion, is  fo  great,  as  to  affect  the  next  link  of  the  aiTociate  train  ; 
which  confifts  of  the  capillaries  of  the  fkin  or  other  glands  ;  thefe 
therefore  are  exerted  perpetually  with  great  increafe  of  action. 

The  continued  fevers  with  flrong  pulfe  terminate  by  the  re- 
duction or  exhauftion  of  the  fenforial  power  by  violent  action 
pf  the  whole  fyflem  ;  which  is  followed  either  by  return  of 
health  with  the  natural  quantity  of  irritability,  and  of  aflbciabil- 
|ty,  or  by  a  total  definition  of  them  both,  and  confequent 
death. 

In  continued  fevers  with  weak  pulfe  the  ftomach  remains 
torpid  during  the  whole  courfe  of  the  fever  ;  and  at  length  by 
the  recovery  of  its  irritability  and  fenfibility  effe&s  the  cure  of 
it.  Which  generally  happens  about  the  firft,  fecond,  or  third 
quarter  of  the  lunar  period,  counted  from  the  commencement 
of  the  difeafe,  or  continues  a  whole  lunation,  and  fometimes 
more  ;  which  gave  rife  to  what  are  termed  critical  days.  See 
Sec~V.  XXXVI.  4.  on  this  fubjeft.  If  the  ftomach  does  not  re- 
cover from  its  torpor,  the  patient  becomes  emaciated,  and  dies 
exhaufted  by  the  continuance  of  the  increafed  action  of  the  ca- 
pillaries and  abforbents,  and  the  want  of  nourifhment. 

The  cure  of  continued  fever  with  weak  pulfe  confifts  firft  in 
weakening  the  undue  action  of  the  capillaries  of  the  flcin  by  ab- 
lution with  cold  water  from  32  to  80  degrees  of  heat ;  or  by  ex- 
pofmg  them  to  cool  air.  Secondly  by  invigorating  the  actions 
of  the  ftomach,  by  decreafmg  them  for  a  time,  and  thence  ac- 
cumulating the  power  of  irritation,  as  by  an  emetic,  or  by  iced 
water,  or  iced  wine.  Or  by  increafe  of  ftimulus,  as  by  bark, 
wine,  opium,  and  food,  in  fmall  quantities  frequently  repeated. 
Or  by  renewing  the  action  of  the  ftomach  by  flight  electric 
(hocks.  Or  by  fomenting  it  frequently  with  water  heated  to  96 
or  100  degrees.  Or  laftly  by  exciting  its  power  of  afibciation 
with  other  parts  of  the  fyftem,  as  by  a  blifter  ;  which  fucceeds 
beft  when  the  extremities  are  cool ;  or  by  fwinging,  as  in  verti- 
go rotatoria. 

If  by  the  ftirnulus  of  the  Peruvian  bark  on  the  fibres  of  the 
ftomach,  they  regain  their  due  action,  the  heart  and  arteries  alfo 
regain  their  due  action  ;  as  their  fenforial  power  of  ailbciation 
js  now  excited,  and  expended  as  ufual.  And  as  there  is  then 
rio  accumulation  of  fenforial  power  in  the  heart  and  arteries,  the 

capillaries 


SUP.  I.  i&  10.        THEORY  OF  FEVER.  509 

capillaries  ceafe  to  act  with  too  great  energy,  and  the  fever  is 
cured. 

Thirdly.  If  the  heart  and  arteries  could  be  themfelves  ftim- 
ulated  into  greater  action,  although  the  ftomach  remained  tor- 
pid, they  might  probably  by  expending  a  greater  quantity  of  the 
fenforial  power  of  irritation,  prevent  an  accumulation  of  the 
fenforial  power  of  aflbciation,  (for  thefe  may  poifibly  be  only 
different  modes  of  action  of  the  fpirit  of  animation,)  and  thus 
the  too  great  action  of  the  capillaries  might  be  prevented  and 
the  fever  ceafe.  This  new  mode  of  cure  might  poffibly  be  ac- 
complifhed,  if  the  patient  was  to  breathe  a  gallon  or  two  of  pure 
or  diluted  oxygene  gas  frequently  in  a  day  ;  which  by  pafiing 
through  the  moid  membranes  of  the  lungs  and  uniting  with  the 
blood  might  render  it  more  ftimulant,  and  thus  excite  the  heart 
and  arteries  into  greater  action. 

Fourthly.  Greater  energy  might  probably  be  given  to  the 
whole  fyftem,  and  particularly  to  thofe  parts  which  a6t  too  fee- 
bly in  fevers,  as  the  ftomach  and  the  heart  and  arteries,  if  the 
action  of  the  fecerning  veflels  of  the  brain  could  be  increafed  in 
energy  ;  this  is  probably  one  effect  of  all  thofe  drugs,  which 
when  given  in  large  quantity  induce  intoxication,  as  wine  and 
opium.  And  when  given  with  great  caution  in  fmall  quanti- 
ties uniformly  repeated,  as  from  three  drops  to  five  of  the  tinc- 
ture of  opium,  but  not  more,  every  fix  hours,  I  believe  they  fup- 
ply  an  efficacious  medicine  in  fevers  with  great  arterial  debility ; 
and  the  more  fo,  if  the  Peruvian  bark  be  exhibited  alternately 
every  fix  hours  along  with  them.  There  are  other  means  of  ex- 
citing the  veflels  of  the  brain  into  action ;  as  firft  by  decreafing 
the  ftimulus  of  heat  by  temporary  cold  fomentation  ;  fecondly, 
increafmg  the  itimulus  of  heat  by  long  continued  warm  fomen- 
tation •,  thirdly,  by  electricity,  as  very  fmall  (hocks  pafled  through 
it  in  all  directions  •,  and  laftly  by  blifters  on  the  head.  All  thofe 
require  to  be  ufcd  with  great  caution,  and  efpecially  where  there 
exifts  an  evident  ftupor,  as  the  removing  of  that  is  I  believe  fre- 
quently injurious.  See  ftupor,  Clafs  I.  2.  5.  10. 

The  cure  of  fever  with  ftrong  pulfe  confifts  in  the  repeated 
ufe  of  venefection,  gentle  cathartics,  diluents  ;  medicines  pro- 
ducing ficknefs,  as  antimonials,  digitalis  ;  or  the  refpiration  of 
carbonated  hydrogen  ;  or  by  refpiration  of  at  mo fpheric  air  low- 
ered by  a  mixture  of  hydrogen,  azote,  or  carbonic  acid  gas,  or 
by  compreffing  the  brain  by  whirling  in  a  decumbent  pofture, 
as  if  lying  acrofs  a  horizontal  mill-ftone.  See  the  former  part? 
of  this  fupplement  for  the  methods  of  cure  both  of  fevers  with 
itrong  and  weak  pulfe. 

10.    When  any  difficulty  occurs  in  determining  the  weak 


510  THEORY  OF  FEVER.         SUP.  I.  16.  10. 

pulfe  from  the  ftrong  one,  it  may  generally  be  aflifted  by  count- 
ing its  frequency.  For  when  an  adult  patient  lies  horizontally 
in  a  cool  room,  and  is  not  hurried  or  alarmed  by  the  approach  of 
his  phyfician,  nor  ftimulated  by  wine  or  opium,  the  ftrong  pulfe 
feldoms  exceeds  118  or  120  in  a  minute  ;  and  the  weak  pulfe 
is  generally  not  much  below  130,  and  often  much  above  that 
number  ;  except  where  a  patient  has  naturally  a  pulfe  flower 
than  ufual  in  his  healthy  ftate.  Secondly  in  fitting  up  in  bed, 
or  changing  tjpe  horizontal  to  a  perpendicular  pofture,  the  quick- 
nefs  of  the  weak  pulfe  is  liable  immediately  to  increafe  10  or 
20  pulfations  in  a  minute,  which  does  not  I  believe  occur  in  the 
ftrong  puliif,  when  the  patient  has  refted  himfelf  after  the  exer- 
tion of  rifing. 

I  (hall  here  infert  a  remark  on  the  general  ufe  of  ftimulating 
materials,  whether  medicinal  or  culinary,  to  counteract:  or  pre- 
vent debility.  When  a  ftimulating  material  is  exhibited,  as  the 
Peruvian  bark,  or  opium,  or  wine  ;  it  fhould  be  continued  but 
a  certain  time,  as  half  a  lunation,  or  a  whole  lunation.  If  the 
whole  fyftem  be  ftimulated  into  increafed  exertion,  as  by  wine 
or  opium,  there  appears  to  be  a  temporary  increafed  fecretion  of 
fenforial  power  in  the  brain,  fo  long  as  this  ftimulus  affects  the 
fyftem.  If  a  part  only  of  the  fyftem  be  ftimulated,  as  by  the 
exhibition  of  fpices,  eflential  oils,  or  bitter  medicines,  or  metal- 
lic ones,  then  the  ftimulated  organ  has  derived  to  it. a  greater 
quantity  of  fenforial  power,  or  a  greater  fecretion*  of  it  is  pro- 
duced in  that  part  of  the  brain,  where  the  ftimulated  nerves 
arife.  Which  is  probably  owing  to  the  fympathy  of  the  ftimu- 
lated extremity  of  every  nerve,  or  its  organ  of  fenfe,  with  the 
other  extremity  of  it  in  the  brain,  in  the  fame  manner  as  when 
the  excretory  duct  of  a  gland  is  ftimulated,  a  greater  fecretion 
is  produced  in  the  body  of  it,  as  when  the  ducts  of  the  lacrymal 
glands  in  the  eyes,  or  of  the  falivary  glands  in  the  mouth  are 
ftimulated  by  duft  or  acrid  materials. 

Now  if  a  ftimulating  medicine  be  given  at  certain  intervals  of. 
time,  as  the  Peruvian  bark  or  wine  in  fevers,  the  increafed  ac- 
tion of  a  part  or  of  the  whole  fyftem  foon  becomes  a  link  of 
the  aflbciated  'circle  of  diurnal  actions,  and  may  be  faid  to  be- 
come habitual. 

The  quantity  of  the  ftimulating  medicine  may  then  be  dimin- . 
iihed,  and  yet  the  increafed  activity  of  the  fyftem  will  continue  5 . 
becaufe  the  increafed  exertions  are  now  produced  partly  by  the 
fenforial  power  of  a{Tociation,  as  they  are  become  a  part  of  the . 
diurnal  circle  of  actions.     And  finally  the  ftimulating  medicine 
may  be  totally  omitted,  and  yet  the  increafed  activity  of  the  fyf- 
tem continue  for  the  fame  reafon. 

On 


SUP.  I.  17.  THEORY  OF  FEVER.  511 

On  this  circumftance  depends  the  power  of  the  bitter  medi- 
cines, as  the  bark,  and  other  flimulating  materials,  as  beer  and 
wine,  in  preventing  the  returns  of  the  cold  paroxyfmsof  fevers, 
and  in  flrengthening  the  fyftem,  which  increafe  of  irritability, 
that  is  of  ftrength,  continues  after  the  ufe  of  the  medicine  is 
withdrawn. 

But  on  the  contrary,  if  the  ftimulating  material  be  continued 
much  longer  than  one  lunation,  the  whole  fyftem,  or  the  ftimu- 
lated  organ  alone,  is  excited  into  too  forcible  aclion  by  the  two 
fenforial  powers  of  irritation,  and  of  aflbciation*;  and  confe- 
quently  in  procefs  of  time  lofes  in  fome  degree  both  its  irrita- 
bility and  its  aflbciability  ;  and  inactivity  or  torpor  fucceeds  ; 
which  conftitutes  weaknefs,  as  is  feen  in  all  thofe,  who  accuf- 
tom  themfelves  to  dram-drinking. 

Hence  wine  or  opium,  or  Peruvian  bark,  may  be  continued 
twice  or  four  times  a  day  for  half  a  lunation,  or  for  a  whole 
one  with  advantage  in  difeafes  of  debility,  for  the  purpofe  of 
gaining  both  diurnal  and  monthly  aflbciations  of  activity.  But 
ihould  not  be  much  longer  continued  j  as  a  confequent  debility 
will  then  be  liable  to  fucceed. 

XVII.    Conclujton. 

Thus  have  I  given  an  outline  of  what  may  be  termed  the 
fympathetic  theory  of  fevers,  to  diftinguifh  it  from  the  mechan- 
ic theory  of  Boerhaave,  the  fpafmodic  theory  of  Hoffman  and 
of  Cullen,  and  the  putrid  theory  of  Pringle.  What  I  have 
thus  delivered,  I  beg  to  be  confrdered  rather  as  obfervations  and 
conjectures,  than  as  things  explained  and  demonitrated  ;  to  be 
confidered  as  a  foundation  and  a  fcaftbldiag,  which  may  enable 
future  induftry  to  erect  a  folid  and  a  beautiful  edifice,  eminent 
both  for  its  fimplicity  and  utility,  as  well  as  for  the  permanency 
of  its  materials, — which  may  not  moulder,  like  the  ftruclures 
already  erected,  into  the  fand  of  which  they  were  compofed  ; 
but  which  may  (land  unimpaired,  like  the  Newtonian  philofo- 
phy,  a  rock  amid  the  wafte  of  ages  ! 


END    OF    THE    SECOND    PART. 


LINES* 


LINES, 

TO    BE    PLACED    AT    THE    EN&    dr 

Z  O  O  N  O  M  I  A 

BT  A  FRIEND. 

| 

OPUS    EXEGI. 


The  work  is  done  !  —  nor  Folly's  adive  rage, 
Nor  Envy's  felf,  (hall  blot  the  golden  page  ; 
Time  fliall  admire,  his  mellowing  touch  employ, 
And  mend  the  immortal  tablet,  not  deftroy. 


ZOONOMIJE    AUCTORI 

S.  P.  D. 
A  M  I  C  U  S. 


CURRUS    TRIUMPHALIS 


Currus  it  Hygeise,  Medicus  movet  arma  triumphans, 
Undique  vidla  fugit  lurida  turma  mali. 

Laurea  dum  Phcebi  viridis  tua  tempora  cingit, 
Nee  mortale  fonans  Fama  coronat  opus  ; 

Poft  equitat  trepidans,  repetitque  Sene&us  in  aurern, 
Voce  canens  ftridula,  «  fis  memor  ipfe  mori !" 


INDEX 

tO    THE 

CLASSES  OF  PART  SECOND. 


A, 


A. 


.BORTION,  i  2.  r.  14. 

from  fear,  iv.  3. 

i.  7. 
not  from  epilepfv , 

iii.  i.  i.  7. 
not  from  hepati- 
tis, ii.  i.  2    iz. 
Abforption  of  folids,  i.  2.  2.  14. 

of  matter,  ii.    i.  6.  a. 

and  6. 

cellular,  iv.  i.  i.  6. 
from  the  lungs,  iv  3.  i. 

5.  Suppl.  i.  8.  6. 
Abftinenee  of  young  ladies,  ii.  ^. 

2.  I. 

Accumulation  of  feces,  ii.  a.  a.  7. 
Acupuncture,  iii.  i.  i.  8. 
Adipfia,  ii.  2.  2.  2. 
j^gritudo  ventriculi,  i.  2.  4.  4. 

See  ^icknefs. 
Agripnia.     See  Vigilia. 
Ague-cakes,  Suppl.  i.  2.  3 
Alum  in  ulcers  of  the  mouth,  ii.  i, 

3.  i.  ii.  t.  6.  16. 
Ambition,  iii.  i.  2.  9. 
Amaurofis,  i.  2.  5.  5. 
Anafarca  of  the  lungs,  i»  2.  3.  16- 
Aneurilma,  i.  2.  i.  18. 
Anger,  iii.  i.  2.  17. 

tremor  of,  iv.  2.  3.  4. 
blulh  of,  iv.  2.  3.  5. 
Angina.     See  lonftlhtis. 

peftoris.      See    Afthma 

painful. 

Anhelitus,  ii.  i.  i.  4. 
Anhelatio  fpafmodica,  i.  3.  3.  3. 
Annulus  repens,  ii.  i.  5.  10. 
Anorexia,  ii.  2.  2.  i . 

maniacalis,  SuppKi- 14.^ 
epileptica,  ii.  2.  2.  i.  iii, 

i.  i.  7. 

Apepfia,  i.  3.  i.  3.     Suppl.  i.  8.  n. 
Aphtha,  ii.  i.  3.  17. 
Apoplexy,  iii.  2.  i.  »6. 
Appetite  defective,  ii.  2.  a.  i. 
depraved,  iii.  i-  a.  19. 
from  abitinence,ii.  2.  2.  t. 
VOL- H,  Ssf 


Appetite  destroyed,  iii.  i.  i.  io. 

from  epilepfy,  ii.  2.  2.  i, 
Arm,  pain  of  iv    2.  2    13. 
palfy  of,  iii.  2.  1.4. 
Arfenic  in  tooth-ach,  i.  2.  4. 12- 
in  head-ach,i.  2.  4.  u, 
Arthrocele,  ii    1.4.  17. 
Arthrppuoiis,  ii.  i.  4. 18. 
Arthritis.     See  Gout. 
Afcandes,  i.   i.  4.  12.  iv.  i.  z.g, 

iv.  2..  2.  6. 
Afcites,  i.  2.  3.  T-J. 
AlTociations  affected  four  ways,  iv. 

i.  i    G 
how  produced,  iv.  i, 

i-  H. 

diftincl:  from  catena- 
tions, iv.  i.  i.  A. 
Affociations,  three  kinds  of,  iv.  i. 

t.    B. 

tertian,  iv.  i.  i.  K. 
of  the  fauces  and  pu- 

bis,  iv.  1.2.7. 
fenlitive,  a  lawpf,  iv, 

2    a.  2. 

fenfitive,  iv.  2   i. 
accumulates,  Suppl.  i. 

8  3.  i.  11.4. 
Aflhma  humoral,  ii.  i.  i.  8.  i.  3, 

2.  8 

of  infants,  1.1.3.4. 
convulfive,  iii.  i.  j.  10. 
pa  ntul,  iii.  i.  i.  n. 
Auditus  acrior,  i.  i.  5  2. 

imminutus,  i.%2.  5.  6, 
Azote,  ^uppl.  i.  9.  3  \   n.  4, 
fceptic,  ii.  i.  6.  6. 

B. 

Bandages,  ill  effect  of,  ii.  i.  i.  11. 
promote  abibrption,  i.  K 
.  3-  '3- 

in  gout,  iv.  i.  2.  15. 
in  rheumatifm,  iv.  i.  y., 

16. 

in  heinicrania,  iv,  2.  2-  8. 
in  epilepiia,  iii.  i.  i.  7. 
Bath, 


INDEX  TO  THE  CLASSES._PA*T  II. 


Bath,  cold,  i.    2.  2.   j,  Suppl.    r. 

.H.  3- 

warm,  i.  i.  2.  3. 
Beauty,  iii.  i.  2.  4. 

lofs  of,  iii.  1-2.  12. 
Bile-du£t,  pain  of,  iv.  2.  2.  4. 
Bile  cryftallized,  i.  i.  3.  8. 
Bitter  tafte,  i.  i.  3.  i. 

not  from  bile,  i.  1.3.  i. 
Bleeding.    See  Hemorrhage. 
Bladder,  diftenticn  of,  ii.  2.  2.  6. 
ttone  of,  i.  i.  3.  10- 
catarrh  of,  ii.  1.4.  n. 
Blfcidnefs,  i.  2.  5.  5. 
Blufh  of  anger,  iv.  2.  3.  5.  Suppl. 

i.  12.  7. 
of  guilt,  iv.  2.  3.6.  Suppl.  i, 

12.  7._  m 
Bones,  innutrition  of,  i.  2.  2.  14. 

caries  of,  ii.  i.  4.  19. 
Borborigmus,  i.  3.  i.  9. 
Bougies,  ii.  1-4.  1 1. 
Bowels,  gurgling  of,  i.  3.  i.  9. 
Brachiorum  paralytis,  iii.  2.  i.  4. 
Brain  (timulated,  Suppl.  i.  16.  9. 
Bronchpcele,  i.  2.  3.  20. 
Broth,  i.  2.  4.  8. 
Burns,  i.  i.  3.  13. 
Butterflies,  experiment  on,   i.    i. 

2-   3, 

Buxton  bath  feels  warm,  Suppl.  i. 
16. 

C. 

Cacofitia,  in-  i<  2.  20. 

Calculi  produ6tio,  i.   i.  3.  9.  ii.  i. 

2.    14. 

renis,  i.  i.  3.  9.  iv.  2.3.  3. 
veficae,  1.1.3.  10.  iv.  2.  2.  2. 
Callico  fhirts,  i.  i.  a.  3. 
Callus,  i.  2.  2,  12. 
Canities.     See  Hair  grey. 
Calor  febrilis,  i.  i.  2.  i. 
Calves  fed  on  gruel,  i.  i.  2.  5. 
hydatides  of,  i.  2,  5.  4. 
Cancer,  ii.  i.  4.  16.  ii.  i.  6.  13. 
Cantharides,  large  dofe  of,  iv.  2. 2.  2. 
Carbonic  acid  gas,  Suppl.  i.  9.3. 
Cardialgia,  i.  2,  4.  5. 
Carcinoma,  ii.  i.  4.  16.  ii.  i.  6.  13. 
Caries  odium,  ii.  1.4.  19. 
Catara6t,  i.  2.  2.  13. 
Catarrh,  warm,  i.  i.  2.  7. 

cold,  i.  2.  3.  3. 

lymphatic,  i.  3.  2.  t. 

fenlitive,  ii.  i.  3-  5- 

epidemic,  ii.  i.  3.  6. 

of  dogs  and  horles,  ii.  i. 
3.   6. 

from  cold  (kin,  iv.  i.  i.  5. 

periodic,  iv.  3.  4.  i. 
Catamenia,  i.  2.  i.  10.  ivt  2.  4-  ?• 


Catalepfis,  iii.  2.  i.  9, 
Cats,  mumps  of,  ii.  i.  3.  4. 
Cephalaea  iympathetica,  iv.  2.  x.  7* 

idiopatnica,  i.  2.  4.  n. 

fomniofa,  i.  2.  4.  n. 
Gefarian  operation,  i.  2.  a.  14. 
Charcoal  tooth-powder,  i.  2.  4. 12. 
Cheek,  torpor  of,  iv-  2.  2.  i. 
Chicken-pox,  ii.  i.  3.  15. 
Chin-cough,  ii.  i.  3.  8. 
Child-bed  fever,  ii.  i.  6.  16. 
Children,  new-born,  ii.  i.  i.  12. 

gripes  and  purging  of,  i. 

I.   2.   5. 

Chlorofis,  i.  2.  3.  10.  Suppl.  i.8. 11. 
Chorea  St.  Viti,  iv.  2.  3.  2. 
Citta,  iii.  «.  2.  19. 
Clamor,  iii.  i.  i.  3- 
Clavicular  animals,  ii.  i.  2.  6. 
Clavus  hyftericus,  iv.  2.  2.  8. 
Claudicgtio  coxaria,  i.  a.  2.  17. 
Cold  in  the  head.     See  Catarrh. 
Cold  air  in  fevers,  iii.  2.  i.  12.  iv. 

2.  4.  ii. 

effeasof,  iii.  2.  i.  17. 
how  to  be  ufed,  iv.  i.  i.  4. 
death  from,  iii.  2.  i.  17. 
Colic,  flatulent,  i- 2.  4-  7- 
from  lead,  i.  2.  4.  8. 
hyfteric,  i.  2.  4.  7.  iii.  1. 1. 8. 
Compallion,  iii.  i.  2,  24. 
Confumption,  ii.  i.  6.  7. 
ConvuKion,  iii.  J.  i.  5. 

weak,  iii.  1. 1.  5. 
from  bad  air,  iii.  1.1.5. 
painful,  iii-  i.  i.  6.  iv. 

2.  4.  5. 

Confirmation,  i.  i.  5.  12. 
Conftipation,  i.  i.  3.  5.  ii.  2.  i.  7. 
Contagious  matter  of  two  kinds,  ii. 

i-  3 
is   oxygenated, 

ii.  i.  5. 

produces  fever, 
how,  Suppl.  i. 
16.  7. 

deftroyed  by  ni- 
trous vapour, 
ii.  i.  3. 

deftroyed  by  ful- 
phurous   va- 
pour, ii.  i.  3. 
Cornea  to  perforate,  i.  1.3.  14. 

fears  of  feen  on  milk,  i.  r. 

3-  i4- 

Corpulency,  i.  2.  3.  17. 
Coryza.     See  Catarrh. 
Coftivenefs,  i.  i.  3.  5.  ii.  2.  i.  7. 
Cough  of  drunkards,  ii.  i.  r.  5. 
hooping,  ii.  i,  3.  8. 
hepatic,  iv.  2.  1.8, 
gouty,  iv.  2.  i.  9. 

Cough 


INDEX  TO  THE  CLASSES.-PART  II. 


5*5 


Cough  periodic,  iv.  2.  4-  6.  iv.  3. 

4.  2. 

from  cold  feet,  iv.  2.  i.  7. 
Cows,  peftilence  of,  ii.  r.  3.  13. 

bloody  urine  of,  ii.  i.  3.  13. 
fwelled  by  clover,  ii.  i.  7. 
Cow-pox,  ii.  i.  3.  9. 
Crab-lice,  i.  1.4.  14. 
Cramp,  iii.  i.  i.  13. 

painful,  iii.  i.  i.  14. 
in  diarrhoea,  iv.  i.  2.  10, 
Crapula  ventriculi,  ii.  i.  i.  7. 
Credulity,  iii.  2.  2.  4. 
Critics  novi,  i.  i.  2,  15. 
Croup;  i.  i.  3.  4  ii.  i,  2.  4.  ii.  r.  3.  3. 
Crufta  laclea,  ii.  i.  5.  12. 
Cuds  arida,  i.  1.3.  6. 
Cynanche.     See  Tonfillitis. 

parotidaea.  See  Parotitis. 

D. 

Darknefs  in  fevers,  i.  2.  5.  3. 
Deafnefs,  two  kinds  of,  i.  2.  5.6. 
Debility,  three  kinds  of,  i.  ^.  i. 
Debility  and  ftrength  metaphors,  i. 

2.  i. 

Decuflation  of  nerves,  iii.  2,  i.  10. 
Deglutition,  ii.  r.  i.  i. 

involuntary,  iv.  i.  3.  r. 
Delirium  febrile,  ii.  i.  7.  i. 

of  drunkennefs,  ii.  i.  7.  3. 
maniacal,  ii.  i.  7.  2. 
in  parotitis,  iv.  2.  i.  19. 
Dentition,  i.  1.4.  5. 
Dentium  dolor  a  ftridore,  iv.  i.  2.3. 
Defcent  of  the  uterus,  i.  i.  4.  8. 
Diabetes,  i.  3.  2.  6. 

foul  tongue  in,  i.  i.  3.  i. 
irritative,  iv.  3.  i.  i. 
from  fear,  iv.  3.  i  3. 
Diarrhoea  warm,  i.  i.  2.  5. 

of  infants,  i.  1.2.  5. 
lymphatic,  i  3.  2.4. 
chyliferous,  i.  3.  2.  5. 
cold,  i.  2.  3.  6. 
rheumatic,  iv.  2,  i.  16. 
from  fear,  iv.  3.  i.  4. 
from  toothing,  iv.  2. 2. 14. 
in  fevers,  Suppl,  i.  2-4. 
cure  of,  iv.  i   i.  F. 
Digeftion  increafed by  cold, i v. 1. 1.4. 
decreafed  by  cold,  iv.  i.  2. 

5- 

Digitalis  in  rheumatifm,  iv.  i.  2.  16. 
Diluents,  ufe  of,  ii.  i.  2.  i. 
Diftention  of  the  nipples,  ii.  i.  7. 

10.  iv.  r.  2.  7. 

Diuretics  ufelefs  in  dropfy,i.  i.  3.7. 
Dizzinefs.     See  Vertigo. 
Dogs,  catarrh  of,  ii^  i.  3.  6. 
Dolor  digiti  lympathet.  iv.  2.2.  12. 
dutfus  choledocht,  iv.  2,2.4. 


Dolor  humeri  in  hepatidite,  iv.  2.  2. 

9- 

pharyngis  ab  acido,  iv.  2.  2.  5. 
tedium  nephriticus,  iv.  2.  ^. 

if. 

urens,  i.  i.  5.  10. 
Dracunculus,  i.  i.  4.  13. 
Dreams,  ii.  i.  7,  4- 
Dropfy  of  the  brtun,  i.  2.  3.  12. 
of  the  belly,  i.  2.  3.  13. 
of  the  chelt,  i.  2.  3.  14. 
of  the  ovary,  i  2.  3.  15. 
of  the  lungs,  i.  2.  3.  16. 
of  the  fcrotum,  i.  2.  3.  n. 
Dyfentery,  ii.  i.  3.  18. 
Dyfmenorrhagia,  i.  2.  i.  12. 
Dyfpepfia,  i.  3.  i.  3. 

a  frigore,  iv.  2,  r.  6. 
Dyfpnosa  from  cold  bath,iv.  2.  i.  5, 

rheumatica,  iv.  ?.  r.  16. 
Dyfuria  infenfitiva,  ii.  2.  2.  6. 
paralytica,  iii.  2.  1.6. 


E. 


Ears,  discharge  behind,  i.  r.  2.  9. 

noife  in  them,  iv,  2.  i.  15. 
Ear-ach,  iv.  2.  2.  8. 
Ebrietas,  i.  i.  i.  T.T 
Education,  iii.  2.  i.  8.  iii.  \.  2.  24. 

iii.  i.  2.  ii. 
.heroic,  iii.  r.  2.  25. 
Egg  boiledSNFor  enflamed  eyes,  ii.  i. 

4.  r. 

boiled  foonefl,  Suppl.  i.  7. 
life  of,  iv.  i.  4.  i. 
Eleftric  fhocks,  iv.  i.  4.  5. 

in  paralylis,  iii.  2. 1.  10. 
in  fcrofula,  i.  2.  3.  21. 
in  hparfenefs,  iii.  2.  1.5. 
Electrized  zinc  and  filver,  i.  2.  ;. 

5.  iv.  2.  i.  ii. 
Empyema,  ii-  I.  6.  4. 
Ennui,  iii.  i-  2.  u.  iii.  2.  i.  8. 
Enteralgia  rheumatica,  iv.  i.  2.  16. 
Enteritis,  ii.  i.  2.  n. 

fftperficialis,  ii.  i.  3.  20. 
Epilepfy,  iii.  i.  i.  7.  iv.  3   i  6. 

painful,  iii.  i.  i.  8.  iv.  2. 

4-  4. 
terminates  with  fleep,  iii. 

i.  i. 

in  parturition,  iii.i.  1.7. 
with  digeftion,  ii.  2.  i.  i. 
Epiflaxis.    See  Haemorrhagia* 
EpouloHs.    See  Cicatrix. 
Erotomania,  iii.  i.  2.  4. 
Eru6lation,  voluntary,  iv.  3.  : 
Eruption  of  fmall-pox,  iv.  ».  i.  n. 

iv.  2.  2.  10. 

Eryfipelas,  iv.  i,  2.  17.  ii.  i.  3.  2. 
iv.  2.  4.  i°« 


INDEX  TO  THE  CLASSES.— PART  II. 


Eryfipelas  feldom  fuppurates,  why, 

ii.  i    3  .  "2 
£  furies,  i.  j   4  a. 
Ether,  to  purify,  i.  ^.  5.  6. 
Evil,  i   2.  3  21. 

Expectoration,  warm,  i   »  2-8. 
folid,  i- 1.  3  4« 
cold,  i.  2  3  4. 
Exfudation  behind  the  cars,  i.  i. 

a.  9. 
Eyes,  blue  under  the,  i.  2.  2.  a.  ii. 

"K  4-  4.    . 

Eye-wing,  n  r    4.  a. 
Eye  lids,  red,  ii.  i  4-  3« 
Eyelid  inverted,  cure  of,  ii-  i- 1.  *; 
coloured  with  antimony,  ii. 

i   4-3. 
Excoriations,  uu  a.  i.  10- 

F. 

Face,  pimpled,  ii  i  4  6. 

red  after  meals,  Suppl  i.  is, 

flufhed  after  dinner,  iv.  1. 1. 1. 
Fat  people  why  ftiort  breathed,  ii. 

i.  1.4. 

how  to  reduce,  i.  a.  3. 17, 
Fear,  fyncope  from,  i   2-1.4.. 
abortion  from,  iv   i.  3.  7. 
produces  abforption,  ii.  i.  6, 4. 
paienefs  in,  iv.  I  3  5. 
of  death,  iii.  \   a  14. 
of  hell,  iii.  i.  2.  15. 
of  poverty,  iii.  i   2.  13. 
Feet   cold     produces    heartburn, 

Suppl.  i.  8.  5. 
fetid,  i.  i.  2.  14. 
cold  in  finall-pox,  iv.  a.  a. 

JO, 

Fevers,  five  kinds,  ii.  i.  a.  Suppl. 

i.  i    ?. 
irritative,  i.  1. 1.  i.  iv.  i.  i. 

8. 
inirritative,  i.  a.  i.  I-  iv.  a. 

I.  19       Mlppl     1-   I.    2. 

fenfitive,  ii  i  ^  i. 
fenfitive  irritated-,  ii  I   a- 1. 
fen  itiveinirritated,  ii.  1.3. 

i 

intermit,  why,  Svippl.i. 
continue,  why,  Suppl.  i. 
periods  of,  iv.  i   4.  ii. 
iimple,  Suppl  i  i. 
compound,  :uppl   i-  a. 
termination    01    cold   fit, 

^uppl.  i   3. 

return  of  cold  fit,  Suppl .  i.  3. 
fenfationin,  ^uppl.  i   5 
circles  of  motions  in,  S 

i   6 

Cold  and  hot  fits,  Suppl, 1. 
continued,  Suppl.  i-  8. 


Fevers,  torpor  of  lungs  in,  Suppl.  i. 

9.  i. 
not  de terminable  in  cold 

fit,  i.  i.i.  i. 
frequency  of  pulfe  in,  i.  x. 

i.  i. 
not  an  effort  to  cure,  i.  i . 

a-  3 
from  enclofed  matter,  ii. 

i    6.  a. 
from  aerated  matter,  ii.  x. 

6.6- 
from  contagious  matter,  ii. 

i  6.  n. 
from  contagious  fanies,  ii. 

i.  6.  15. 

puerperal,  ii.  i.  6.  16. 
torpor  of  the  ftomach  in, 

Suppl-  i.  12. 
cafe  of,  Suppl.  i.  13 
termination  of,  huppl.  i.  14. 
inflammation    excited    in, 

Suppl  i-  15- 
returns  of,  Suppl  i.  4- 
when  cold  air  in,  Suppl.  i. 

a.  a. 
fympathetic»    theory    of, 

Suppl  i. 
duration     of     explained, 

Suppl.  i.  a.  5. 
Fingers,  playing  with,  iv.  i.  3.  4. 

pain  of,  iv.  a.  2.  12. 
Fire,  animal,  iv.  i,  4.  5. 
Fifh  live  longer  with  injured  brain^ 

i.  2.  5.  10. 
Fiftula  in  ano,  ii.  i .  4.  10. 

lacrymalis,  ii.  i    4-  9« 
in  urethra,  ii.  i.  4.  11. 
Flannel  fhirt  in  diarrhoea,  iv.  i  i.  j. 
injurious  in  fummert 

i.  j.  2.  3. 
Fluor  albus  warm,  i.  i.  a.  xi. 

cold,  i.  2.  3.  7. 
Frigus  febrile,  i.  a-  a-  t. 

chronicum,  i.  2.  a.  a. 
lethale,  iii.  a.  i.  17. 

G. 

Galvanifm,  i.  a.  5.  5-  iv.  a.  i.  if, 
Gall-flone,  i.  1.3-  8. 
Gangrene,  ii.  1.6.  17. 
Gargles,  ii.  i.  3.  3- 
Gaftritis,  ii.  i.  2.  10. 
Gaftritis  fuperficialis,  ii.  i.  3.  i«, 
Genu  tumor  albus,  i.  a.  3.  19. 
Gleet.     See  Gonorrhoea. 
Globus  hyftericus,  i.  3.  i.  7- 
Gonorrhoea  warm,  i.  i.  a.  10. 

Cold,  i.  a.  3.  8. 

venereal,  ii.  i.  5.  2. 


ipLi,7.    Gout,  iv.  i.  2.^5.  iv.  2.4.9. 
8.  of  the  livV,  ii.  i.  i.  ?• 


GoutA 


INDEX  TO  THE  CLASSES.-PART  TT, 


5r7 


Gout,  cafes  of,  iv.  i.  2.  15. 

cough, 5 v.  t.  i.  9. 

of  the  ftomach,  i.  2.  4.  6. 

haemorrhage  in,  i.  i.  i.  4. 
Grace  defined,  iii.  1.24. 
Gravel  diltinguiflied  from  falts,  i- 

'•3-9 

Gravitation,  iv.  2.  4. 
Green-iicknefs.     See  Chlorofis. 
Grief,  iii    i.  2    10- 


Heat,  not  eftimated  by  thermome- 
ters, Suppl   i.  7. 
of  the  breath,  Suppl.  i.  2.  2. 
Hemicrania  idiopathica,  i.  2.  4.  12. 
fympathetica,  iv   2.  2. 
8    iv.  ^.   4.  3.  SuppK 
i.  14.3. 
relieved  by  mercury, 

iv.  2,  2    8- 
Hemiplegia,  iii  2   i.  10. 


Gripes  of  children,  i.  i,  2.  5.  iv.  2.     HepatU  tumor,  i-  2.  3.  9. 


Guftus  acrior,  i.  i.  5.  4, 

imminutus,  i.  2,  5.  8. 
Gum,  red,  i.  i.  2.  3.  ii   i    3.  12. 
Gutta  rofea,  ii.  i.  4.  6.  iv.  i.  2.  13. 

and  14. 
ferena,  i.  2.  5.  5. 

H. 

Hemorrhage  arterial,  i.  i.  r.  3. 

of  the  lungs,  i.   i.  i. 

of  the  nofe,  i.  x.  i. 

5- 

venous,  i.  2.  i.  5 


Hepatitis,  ii   12    12. 

chronica,  ii.  i.  4.  12. 
Herpes,  ii.  1.5  8. 

nephritica,  iv.  i.  2.  n. 
Hiccough,  ii  i.  i.  t.\v   i.  i.  7. 
Hip-joint  injured,  i,  2.  2.  17. 
Hoarfenefs,  ii.  i.  3.  5.  i  i.  2.  i.  4. 
Hordeolum,  ii    i.  4  4. 
Hooping-cough,  ii   i.  3.  8. 
Horfes,  broken  wind  of,  i-  2.  4.  9. 

catarrh  of,  ii   i.  3.  6. 
Hume&ation  of  the  body,  iv,  i.  4. 

Hunger,  i.  2.  4   2. 
Hydatides  in  calves,  i.  2.  5,  4. 


of  the  rectum,  i.  2.  i.     Hydrocde,  i.  2   3.  ri 


6. 

of  thekidnies,  i.  a.  i. 

of  the  liver,  i.  2.  r.8. 
Haemoptoe  arterial,  i.  i.  i.  4. 
venous,  i.  2.  i.  9. 
Haemorrhois  cruenta,  i.  2.  i.  6.  iv. 

2.4.  8. 

alba,  i.  i.  a.  12. 
Hair,  grey,  i.  2.  2.  n. 
new,  i,  r.,2.  15. 


Hydrocephalus  inter,  i.  2.  3.  12.  i. 
2.  5    4.  iii.  2.  i. 

JO 

from  inflammation, 

i.  2.  3    ii. 
Hydrogcnc  gas,   Suppl.  i   9.  3.  i- 

ii.  4 

in  fevers,  Suppl. 
i.i  i.  6.  i  16  9. 

Hydrothorax,  i.  2.  3-  14.  cafe  of,  iv. 
2   2.  13. 


white  by  uterine  preflure,  i.    Hydro-carbonate  gas,  Suppl.  j.  9. 

i.  Suppl   i-  15    -> 
Hy  drops  ovarii,  i.  2.  3.  15. 
Hydrophobia,  13.  i.  xi.  iii.  i.  x. 

15   iv.  i.  2  7.  iv   2  4.  ii. 
Hypochondriacs,  i.  2  4.  10. 
Hyneraigia  trigida,  i   2.  4.  17. 
4.    Hyfteria,  i.  3.  i.  10-  £uppl.  i.  x.  8- 

ii. 

from  fear,  iv.  3-1.8. 
from  cold,  iv.  3.  3 .3. 

convultiousui,  iii.  r. 


2.  2.    Ii. 

Hallucination  of  fight,  ii.  i.  7.  5. 

of  hearing,  ii.   J.   7 
6. 

maniacal,  iii    i.  2.  i. 
Hallucinatio  ftudiofa,  iii.  i,  2.  2. 
Harrogate  water,  factitious,  i. 

12. 

Head-ach.      See  Hemicrania   and 

Cephalaea. 
Hearing,  acuter,  i.  i.  5.  2. 

diminiflied,  i.  2.  5.  6. 
Heart-burn,  i.  2.  4.  5. 


>. 
laughter  in,  iii.  i.  i-  5. 


Heart  Simulated,  Suppl.  i.  n.  7.  i.     Hyfteritis,  ii."j.  2.  16. 
16  9 


Heat,  animal,  i.  i.  2.  i.  i.  i.  2.  3. 
ienfe  of  acuter,  i.  i.  5.  6. 
elemental,  iv.  2.4. 


I. 

Jaftitatio,  iii.  i    i-  i. 
Jaundice,  i.  1.3-  8.  i.  a.  4.  19. 


hectic  leilened  by  fwinging,     Icterus,  i.  1.3-8   i.  2.  4.  19 

iv   2   i.  10.  Ileus,  i.  3.  i.  6.  ii.  i.  2.  ii. 

not  perceived  by  the  lungs,    Impotentia,  ii  2.  2.  3. 


ig. 


ladigeftion.  i.  3.  i.  3. 


Indigedion, 


TO  THE  CLASSES.— PART  II. 


Indigeflion.  See  Anorexia  and  A- 

pepfia. 
from  cold  feetuv.  2.  i, 

6.     Sup.  i.  8.  5. 
Incubus,  iii.2. i. 13. 
Infants,  green  ftools  of,  i.  i.  2.  5. 

new  born,  ii.  i.  i.  13. 
Inflammation  of  the ;  eye,  ii.  i    2.  2. 
Superficial,  ii.  i.  4.  i. 
of  the  brain,  ii.  i.  2. 

of  the  lungs,  ii.  i.  2. 

4- 

fuperficial,  ii.  1.3.  7. 
of  the  pleura, ii.  i.  2. 

of  the  diaphragm,  ii. 

i.  2.  6. 

of  the  heart,  ii.  i.  2.  7. 
of  the  peritoneum,  ii. 

i.  2.  8. 
of  the  inefentery,  ii. 

1.  2.  9 

of  the  ftomach,  ii  z. 

3.   10. 

fuper- 
ficial, ii.  i.  3.  19. 

of  the  bowels,  ii.  i.  2. 
n. 

fuper- 
ficial, ii.  i.  3.  20. 

of  the  liver,  ii.  i.  2. 
12. 

chronical,  ii.  1.4.  12. 

of  the  fplcen,  ii.  i.  2. 
13.  Sup.  i.  16.  6. 

of  the  kidnies,  ii.  i, 

2.  14. 

of  the  bladder,  ii.  i. 

2.  15. 
of  the  womb,  ii.  1.2. 

16. 
of  the  tonfils,  ii.  i.  3. 

of  the  parotis,  ii.  i.  3. 

4 

Inirritability  of  lacteal s,i.  a.  3.26. 
of  lymphatics,  i.  2.  3. 

27. 
of  the  gall-bladder,  i. 

2.  4   i?- 
of  the  kidney,  i.  2.4. 

20. 
of  the  fpleen,  Sup.  i. 

1 6.  6. 

viciflitudes  of,  i-  i.  I. 
Innutrition  of  bones,  i.  2.  2.  14. 
Inoculation,  ii.  i.  3.  9- 
lufanity,  quick  pulfe  in,  iijkt.  i. 
from  parturition,  iii.  I.  2. 
from  paralylis,  iii.  I.  a. 


Infanity,  with  fever,  iii.  i.  2. 

cure  of,  iii.  i.  2. 

confinement  in,  iii.  i.  2. 

cures  other  difeafes,  i.  2.  3. 

16. 

Infenfibility,  ii.  2.  i.  i. 
Introfufception  of  the  inteftine,  i. 

T   3 ..i:6. 

Ira,  111.  i.  2   17. 

Ifchias,  ii.  i.  2.  18.  i.  2.4.  15. 

I  flues,  ufeof,  i.  i.  a.  9.  iii.  i.  i.  n. 

Itch,  ii.  i.  5.  6. 

Itching,  i.  i.  5,  9. 

of  the  nofe,  iv.  2.  2.  6. 

K. 

Kanguroo,  i.  2.  2.  14. 

L. 

Labour,  difficult,  i,  2.  2.  14. 
Lachrymarum  fluxus  fym.  iv.  i.  3. 

i. 

Lamcnefs  of  the  hip,  i.  2.  2,  17. 
Latitude,  iii.  2.  i.  i. 
Laughter,  iv.  2.  3.  3.  iii.  I.  i.  4.  iv, 

!•  3-  3« 

See  Rifus. 

Lead,  pernicious,  i.  2.  4.  8. 
Leg,  one  ihorter,  i.  2.  a.  17. 
Lepra,  ii.  i.  5.  3. 
Lethargus,  iii.  2.  i.  14. 
Lethi  timor,  iii.  i.  2.  14. 
Lice,  i.  i.  4- 15. 
Lientery,  i.  2.  3.  6. 
Life  of  an  egg.  iv.  i.  4.  i. 

of  winter-fleepers,  iv.  i.  4.  2. 
Light  debilitates  in  fevers,  i.  2.  5. 

Lingua  arida,  i.  1.3.  i.  iv.  2.  4.  u. 
Liver,  torpor  of,  i.  2.  2.  6. 
tumor  of,  i.  2.  3.  9. 
inflamed,  ii.  i.  2,  12. 
Lochia  nimia,  i.  2. 
Locked  jaw,  iii.  i.  i.  13, 
Love,  fentimental,  iii-  i.  2.  4. 
Lues  venerea,  ii.  i.  5.  8. 

imaginaria,  iii.  J.  2.  21. 
Lumbago,  ii.  i.  2.  17.  iii.  i.  j.  i. 

cold,  i.  2.  4.  16. 
Lumbricus,  i-  i.  4.  10. 
Lunar  influence  on  the  folids,  i.  2. 

i.  ii. 
Lungs,  adhefions  of,  ii,  i.  2.  5. 

not  fenfible  to  heat,  iii.  1. 1. 

10. 
Lufus  digitorum  invitus,  iv,  1.3.4. 

M. 

Maculae  vultus,  i.  2.  i.  9. 
Mudnefs,  mutable,  iii.  1.2.  i. 
Magnetic  fluid,  iy.  1.4-5. 

Mammarum 


INDEX  TO  THE  CLASSES.— PART  II. 


51* 


Mammarum  tumor,  iv.  2.  i.  19. 
Mammularum  tenfio,  iv.  2.  i.  6.  i. 

i.  4-  7- 

Mania  mutabilis,  iii.  i.  2.  i. 
Matter,  variolous,  ii.  1.3-9- 

contagious,  ii.  i    3.  ii.  i.  6. 

11. 

enclofed,  ii.  i.  6.  11. 
oxygenated,  ii.  i.  6.  6. 
famous,  ii.  i.  6.  15. 
Meafles,  ii.  i.  3-  10.  Suppl.  i.  16.  6. 
Membranes,  what,  iv.  i.  2. 
Menorrhagia,  i-  2.  i.  11. 
Mercury  crude,  as  aclyfter,  i,  3.  i. 
6. 

in  colic  from  lead,  i.  2.  4. 

8. 
in  all  contagions,  Suppl  i. 

16.  7. 

in  vertigo,  iv.  i.  2.  11. 
Miliaria,  ii.  i.  3.  12. 
Milk  new,  for  children,  i.  i.  2  5. 
old,  induces  coftivenefs,  ii.  i. 

2.  7. 

Milk-craft,  ii.  i.  5.  12. 
Mifcarriage.     See  Abortion. 
Maeror,  iii.  i.  2.  10. 
Mobility,  iv.  i.  2. 

of  the  (kin,  Suppl.  i.  7. 
Mollities  odium,  i.  2.  2.  14. 
Moon,  effect  of»  iv.  2.  4. 
Morbilli.     See  Rubeola. 
Mortification,  ii.    i.  6.    17.  iii.  2.  i. 

10. 

Morpiones,  i.  1.4.  14. 
Mucus  diminifhed,  i.  2.  2.  4. 

of  the  throat  cold,  i.  2.  3.  i. 

of  the  bowels,  i.  2.  3.  6.  i. 
i.  2.  12. 

of  the  lungs,  i.  i.  3.  4. 

forms  ftones,  i.  1.3.9. 

diftinguifhed  from  pus,  ii.  i. 

6.  6. 

Mumps,  ii.  1.3  4. 
Murmur  aurium,  iy.  2.  i.  15. 
Mufcae  volitantes,  i.  2.  5.  3. 

N. 

Nails,  bitingpf,  iv.  i.  3.  5. 
Nares  aridi,  i.  i.  3.  3. 
Naufea,  dry,  i.  2.4.  3. 

humid,  i.  3.  2.  3. 
ideal,  iv.  3.  2.  i. 
from  conception,  iv.  3.  2. 

2. 

Navel-ftring  of  infants,  ii.  i-  i.  12. 
cut  too  foon,  ii.  i.  i. 

12. 
Neck  thickens  at  puberty,  iv.  i.  2. 

-fwing,  i.  2.  2.  16. 


Nephritis,  ii.  i.  2.  14.  i.  i.  3.  9.  iii. 

2.   i.  :4. 

Nerves  decuflate.  iii.  2.  i.  10. 
Nictitation  irritative,  i.  1.4.  i. 
fenfitive,  ii.  i.  i.  9. 
involuntary,  iv.  i.    3.  £» 
Night-mare,  iii.  2.  1. 13. 
Nipples,  tenfion  of,  i.  i.  4.  7.  iv.  2* 
i.  6. 

want  of,  ii.  i.  i.  13. 
Noftalgia,  iii.  i.  2.  6. 
Noftrib,  dry,  i.  i.  3.  3. 

O. 

Obefitas,  i.  2.  3.  17. 
Odontai^ia,  i.  2.  4.  13. 
Odontitis,  ii.  i   4.  7. 
CEfophagi  fcirrhus,  i.  2.  3 
Olfattusacrior,  i.  i.  5.  3. 

imminutus,  i.  2.  5.  7. 
Oil  deftroys  infects,  i    i.  4.  H- 
efTential  of  animals,  i.  i.  2.14. 
why  injurious  in  eryfipelas,  ii. 

i.  3.  2. 
Opthalmy,  internal,  ii.  i.  2.  2. 

fuperficial,  ii.  i.  4.  i- 
Opium  in  catarrh,  i.  2.  3.3. 

in  diaphragmitis,  ii.  i.  2.  6. 
Orci  timor,  iii.  i.  2.  15. 
Ofcitatip,  ii.  i.  i.  10. 
Oflmm  innutritio,  i.  2.  2.  14. 
Otalgia,  i.  2.  4.  13.  iv.  2.  2.  8. 
Otitis,  ii.  1.4.  8. 
Otopuofis,  ii.  i.  4.  8. 
Ovary,  dropfy  of,  i.  2.  3.  15. 

exfeclion  of,  i.  2.  3.  15. 
Oxygen  gas   Suppl.  i.  9.  3. 

in  fevers,  Suppl.   i.  11.  7* 

i.  16  9. 
Oxygenation  of  blood,  iv.  i.  4.  6. 

P. 
Pain  exhaufts  fenforial  power,  iv. 

greater  prevents  lefs,  iv.  2.  2. 

2. 

nervous,  i.  2.  4. 

of  the  little  finger,  fymptom, 

iv.    2.   2.    12. 

of  arm  in  hydrothorax,  iv.  2» 

2. 13. 

of  the  bile-duCl,  iv.  2.  n.  4. 
of  the  (boulder,  iv.  2.  2.  9. 

of  the  pharinx,  iv.  2.  2.  5. 
of  the  tettis,  iv.  2.  2.  11. 
(inarting,  i    1.5.  10. 
of  the  fide,  i.  2.  4.  i4-iv.  i.  2- 

of  menftruation,  i.  2.  i. 
life  of,  iii.  i.  i.  11.  i.  i.  2.  9. 
of  the  uterus,  i.  2.  4.  17. 

te,  dangerous,  ii.  1.46. 
Palate, 


520 


INDEX  TO  THE  CLASSES.-PAkT  It 


Palate,  defeft  of,  i.  2.  2.  20. 
Palenefs,  i.  2.  e.  2. 

from  fear,  iv.  3.  i.  5. 

from  licknefs,  iv.  2.  1.4. 

of  urine  after  dinner,  iv. 

2.1 

from  cold  fkin,  iv  2  i. 1. 
Palpitation  of  heart,  i.  3.  3.  2.  i.  2. 

1.    iO. 

from  fear,  iv.  3.  i.  6, 
relieved  by  arlenic,  iv» 

2    i.  18. 

Pancreas,  torpor  of,  i.  «.  2.  7. 
Pandiculatio,  ii.  i.  i.  10. 
Panting,  ii.  i.  i.  4-  i-  3-  3-  3- 
Paracente'is  at  the  navel,  i.  2.  3. 13. 
Paralyiis,  iii.  a.  i.  10. 

of  the  bladder,  iii.  2.  1.6. 
of  the  re. Him,  iii.  2.  i.  7. 
of  the  hands,  iii.  2.  1.4. 
cure  of,  iii.  2.  1.4. 
Paraplegia,  iii.  _?.  '.  11. 
Pareiis  inirriiativa,  i.  2.  i.  2.  Suppl. 

i.  8.  10. 

fenli'iva,  i.  P..  i.  3. 
voluntaria,  iii.  <2.  i.  8. 
Paronychia,  internal,  ii.  i.  2.  19. 
fuperficial,  ii.  i.  4.  5. 
Parotitis,  ii.  1.3.4- 
Parturition,  ii.  i.  i.  13.  ii-  i-  2.  16. 
more  fatal  in  high  life, 

ii    i.  i.  13- 
with  convuifion,  iii.  I. 

1.  iii    i.  i.  7. 
difficult,  i.  2.  2.  14. 

Paflions.deprelling  and  exciting,  iv« 

3    i-5- 

Paupertatis  timor,  m.  i.  a.  13. 

Pediculus,  i   i-  4  15- 

Pemphigus,  ii.  i.  3-  <4- 

Penetration  of  animal  bodies,  iv.  i. 
4.  7. 

Peripneumony,  n.  i.  2.  4- 

trachea!,  ii.  i.  2.  4- 
fuperficial ,  ii- 1.  3  7- 
inirritated,ii- 1-  2. 4. 

Peritonitis,  ii.  I.  i   8. 

Perfpiration  not  an  excrement,  i- 1. 

2.  14. 

greatelt  in  the  hot  fit^ 

i.  i.  2.  3. 
fetid,  i.  i.  2.  14. 
Pertuflis,  ii.  i.  3  8. 
Peftis,  ii.  i.  3.  13- 
Fetechiae,  i-  2    i.  17. 

cure  of,  Suppl.  i.  i.  7. 
Pharynx,  pain  of,  iv.  2.  a.  5. 
Phofphorus,  ii.  2  2.  3. 
JPhremtis,  ii.  i.  2.  3. 
Phthilis,  pulmonary,  ii.  i.  6.  7. 
Piles,  bleeding,  i.  2.  1.6. 


Pimples  on  the  face,  ii.  1.4.  6. 
Pins  fwallpwed,  ii.  i.  1.7. 
Placenta,  ii.  i.  i.  12.  ii.  i.  a.  16. 
PlagueT-iL-j .  3.  13. 
Plalters,  why  moift,i.  i.  3.  6. 
Pleurify,  ii.  i.  2.  5. 
Pleurodyne  chronica,  i.  a.  4.  14. 

rheumati^a.iv.  1.2.  it. 
Podagra,  iv.  i.  a    i5.*v    a.  4.  9. 
Polypus  of  the  lungs,  i,  i.  3.  4. 

of  the  nofe  from  worms, 
,  iv.  i.  2.  9. 

Pregna^icy,  11.  i.  i.  12. 
Priapi/rnus,  i.  i.  4.  6.  ii.  i.  7.  9. 
Proctalgia,  i.  2.  4.  18. 
Prolapius  ani,  i.  1/4.  9. 
Pruritus,  i.  1.5.  9. 

narium  a  vermibus,  iv.  2. 

2.  6. 
Pfbra,  ii.  i.  5.  6. 

imaginaria,  iii.  i.  a.aa. 
Pterigion,  ii.  i.  4.  a. 
Ptyalifmus.     See  Salivatio. 
Pubis  and  throat  fympathize,  iv.  1. 

i.  7. 
Puerperal  fever,  i.  a.  4.  9.  ii.  i.  6. 

16. 

infanity,  iii.  i.  a.  i. 
Pulchritudinis  defiderium,  iii.  i.  2.- 

12. 

Pullulation  of  trees,  iv.  i.  4  3- 
Pulie  full,  why,  i.  i.  i.  i. 

ftrong,"how  determined,  i.  i. 

1.  i.  Suppl.  i.  16.  10. 

foft  in  vomiting,  iv.  a.  i.  17* 
intermittent,  iv.  2.  i.  18. 
quick  from  paucity  of  blood* 

Suppl.  i.  11.4. 
quick  fbmetimes  in  fleep,  iii, 

2.  1.    12. 

quick  in  vyeak  people,  iii.  1.1. 

iii.  a.  i.  Suppl.  i.  11.  4. 
flower  by  fwmging,  iv.  ^.  i. 

10. 

quick  in  chlorous,  i.  i.  3.  10* 
Punclae  mucofae  yulrus,  i.  a.  a.  9. 
Purging.     See  ETiarrhoea. 
Pus  dimirHfhed,  i.  a.  a.  3. 

di(tingui(hed  from  mucus,  ii.  i« 
6.6. 

R- 

Ratiocinatio  verbofa,  iii.  a.  2.  3- 
Rabies,  iii.  i.  a.  18. 
Rachitis,  i.  2.  2.  15. 
Raucedo  catarrhal,  ii.  i.  3.  5. 
paralytic,  iii.  a.  i.  5- 
Reafoning,  falle.  iii.  2.  2.  3. 
Recollection,  lofs  of,  iii.  2.  a.  *. 
Recti  paralyiis,^  iii.  2.  i.  7. 
lcirrhus,*i.  2.  3.  33. 
Red-gum,  ii^  i.  3-  la.  J'  1-  »•  3-    . 
Re 


INDEX  TO  THE  CLASSES.— PART  It. 


fuppi 


kednefs  from  heat,  ii.  i.  7.  7. 

of  joy.  ii.  i.  7.  8. 

after-dinner,  iv.  i.  i.  i. 

of  anger,  iv.  2.  3.  5. 

of  guilt,  iv.  2.  3.  6. 

of  modefty,  iv.  i.  3.  6. 
Refpiration,  ii.  i.  1.2. 

diuick  in  exercife,  ii. 

1.  i.  3. 

in  foftnefs  of  bones,  i. 

2.  2.  14. 

Reftleflnefs,  iii.  i.  i.  i. 
Retroverfio  uteri,  i.  2.  i.  14. 
Reverie,  iii.  i.  2.  2.  iv.  2.  4.  2. 
Rhaphania,  iii.  i.  1.6. 
Rheumatifm,  iv.  i.  2.  16. 

of  the  joints,  iv.i.  2. 16. 
of  the  bowels,  iv.  i. 

2.  16. 
of  the  pleura,  iv.  i. 

2.  16. 
>u rating,  iv.  1.2. 

16. 

from  fympathy,  iv.  2, 

2.    13. 

chronical,  i.  i.  3. 12. 

iii.  i.  i.  6. 
venefection  in,  iv.  i. 

2.  l6. 

Rickets,  i.  2.  2.  15. 
Ring-worm,  ii.  i.  5.  10. 
Rifus,  iii.  i.  i.  4.  iv.  2.  3.  3. 

fardonicus,  iv*.  i.  2.  4. 

invitus,  iv.  i.  3.  3. 
Jlubeola,  ii.  i.  3.  10. 
Rubor  a  calore,  ii.  i.  7.  7. 

jucunditatis,  ii.  i.  7.  8. 

pranforum,  iv.  i.  i.  i. 
Ruclus,  i.  3.  i.  2. 
Kuminatio,  i.  3.  i.  i.  iv.  3.  3.  i. 

S. 

Sailing  in  phthifis,  ii.  i.  6.  7. 
Salivation  warm,  i.  i.  2.  6. 

lymphatic,  i.  3.  2.  2. 
fympathetic,  iv.  i.  2.  5. 
in  low  fevers,  i.  i.  2.  6. 
Salt  of  urine,  i.  i.  2.  4.'i.  i.  3.  9. 
Satyriafis,  iii.  i.  2.  16. 
Scabies.     See  Pfora. 
Scald-head,  ii.  i.  5.  11. 
Scarlatina,  ii.  i.  3.  11. 
Sciatica  frigida,*i.  2.  4.  15. 
.Scirrhus,  i.  2.3.  22. 

fuppurans,  ii.  1.4.  14. 
of  the  rectum,  i.  2.  3.  23, 
of  the  urethra,  i.  2.  3.  24. 
of  the  cefophagus,  i.  2.  3. 

25- 
Scorbutus,  i.  2.xi.  15. 

fuppuraris,  ii.  I.  4.  14- 
Scrofula,  i.  2.  3.  21. 
VOL.  II,  TTt 


Sgrofula,  fuppurating,  ii.  x.  4.  13. 

produces  inianity,  iii.  i.  2. 
Scurf  of  the  head,  i.  i.  3.  6. 

of  the  tongue,  i.  1.3.  i. 
Scurvy,  i.  2.  i.  15. 

fuppurating,  ii.  i.  4.  14. 
Sea-air  in  phthifis,  ii.  x.  6.  7. 
Sea-fickneis,  iv.  2.  i.  10.  Suppl.  i. 

8.  3- 

Seat,  defcent  of,  i.  i.  4.  9. 
Seed,  ejection  of,  ii.  i.  i.  n. 
See-faw  of  old  people,  iii.  2,  x.  2. 
Senfation  inert,  Suppl.  i,  6.  4. 
Senfitive  aflbciation,  law  of,  iv.  *• 

2.    2. 

Setons,  ii.  i.  6. 
Shingles,  ii.  i.  5.  9. 
Shoulder,  pain  of,  iv.  2.  2-  9. 
Shrieking,  iii.  i.  i.  3. 
Sicknefs,  i.  2. 4.  4.  i.  3.  2.  3. 

cured  by  a  blifler,  iv.  i. 

«•  3- 
by  warm  (kin,  iv.  x.  2,  a, 

Suppl.  i.  ii.  4. 
by  whirling,  i.  i.  1.4. 
by  fwinging,  Suppl.  i.  15* 

by  hydrocafbonate    gasj 

Suppl.  115.3. 

See  Naufea. 
Sight  acuter,  i.  i.  5.  x. 

impaired,  i.  2.  5.  2. 
Side,  chronical  pain  of,  i.  2.  4,  14. 
Sighing  and  fobbing,  iii.  i.  2.  10. 
Sitis  calida,  i.  z.  4.  i. 
frigida,  i.  2.  4-  *• 
detectiis,  ii.  2.  2.  2. 
Skin  pale  in  old  age,  i.  2.  2.  2. 

from  cold,  i-  2.  2.  2. 
Skin  dry,  i.  i  3.  6. 

yellowifti,  i.  2.  2-  2. 
bluifli  and  flirunk,  i.  2.  i.  11 
reddifh,  ii.  x.  3.  i. 
cold  after  meals,  iv.  2,  i.  i. 
Sleep,  iii.  2.  i.n. 

interrupted,  i.  2.  i.  3- 
periods  in,  iv    2.  4.  i. 
with  quick  pulfe,  iii.  2.  x.  it. 
difturbed  by  digeltion,  iii.  2. 

i.  n. 

Sleep-walkers,  iii.  i.  x.  9. 
Small-pox,  ii.  i.  3-  9- 

\vhydiftin6t  and  conflu- 
ent, Sup.  i.  15.  j.i.  16.8. 
fecondary  fever  o 

1.6*  12 

eruption  of,  iv.  T 
Smarting,  i.  i.  5.  10. 
Smell  acuter,  i   j.  5.  3. 

impaired,  i.  2. 
Sneezing,  ii.  1.1.3.  i 
Snow  iii  forofula>  \ 


INDEX  TO  THE  CLASSES.— PART  II. 


S.now  in  paralyfis,  iii.  2.  j.  4. 
Snutf  iir  hydrocephalus,  i.  2.  3.  12. 
Softnefs  or  bones,  i.  2.  2.  14. 
Somnanibulifm,  iii.  i.  i.  9. 
Somniumy ii.  i,  7-4- 
Somnus/iii.  2.  i.  12.  iv  2.4.  i. 
interruptus,  i-  2.  1.3. 
Spafm of  diaphragm,  iii-  i.  i.  rr. 

of  the  heart,  iii.  i.  i.  n. 
Spine  diltorted,  i.  2   2.  16. 

protuberant,  i.  2.  ^.  18. 
bifid,  i.  2.  2.  19. 

Spitting  blood,  i.  i.  j.  4-  i-  2   i-  9- 
Spleen  {welled,  i.  2.  3.  18.  Suppl. 

i.  16.  6. 

Spienitis,  ii.  2.  2.  13. 
tpots  on  the  face,  i.  2.  2.  9. 

feen  on  bed-clothes,  i.  2. 5.  3. 
Squinting,  i.  2.  5.  4. 

in  hydrocephalus,  i.  2. 

5    4. 

Stammering,  iv.  2.  3.  i. 
Stays  tight,  injurious,  ii.  i.  i.  12. 
Sterility,  ii.  2.2.  4. 
Sternutatio,  ii.  i.  1.3.  iv.  i.  2.  a. 
a  lumine,  iv.  2.  i.  a. 
Stimulants,  their  twofold  effeft,  ii. 

i.  2.  6. 
injure  weak  people,  i. 

1.1.  3. 

except  the  for- 
bentia,   i.   i. 
*•  3- 
Stocks  for  children  dangerous,  ii. 

a.  2.  17. 

Stomach,  torpor  of,i.«.  f  i.  Suppl. 

i    \^.  i.  8.  10.  i.  16.  (5. 

inflammation  of,  ii.  i,  2. 

10.  ii.  i.  3.  19. 
its  allbciation,  iv.  r.  i. 
caufe  of  fever,  Suppl-  i. 

8.  8- 

Stones  in  the  bladder..  See  Calculi, 
in  liorfes,  i.  i.  3.  5.  i.  i.  3. 

10- 

Strabifmus,  i.  2.  5.  4. 
Strangury,  ii.  i.  i.  12   iv.  2.  2.  2. 
convulfi.ve,  iv.  2  2   3. 
Strength  and  debility  metaphors,!. 

2   i. 

Sttidor  dentium,  iii.  i.  r.  12. 
Studium  inane,  iii,  1-2.  2.  iv.  2.  4. 

2. 

Stultitia  inirritabilis,  i.  2.  5.  r. 

inrenfibili-s,  ii.  2.  i,  i- 
voluntaria,  iii.  2.  2.  2. 

Stupor,  i.  2.  5.  10.  Suppi.  i.  15. 

Si. ye,  ii.  i.  4-  4 

Subfuluii.  tendinum,  iii.  i.  1.5. 

Sudor.     See  Sweats. 

Suggefiion,  flow,  iv.  2.  3.  8. 

Superannuation,  iv  2, .3    b. 


Surprife,  i.  1.5.  12. 
Sweats,  warm,  i.  i.  2-3. 
cold,  i.  2.  3.  2. 
lymphatic,  i.  3.  2.  7. 
althmatic,  i.  3.  a.  S,  iv.  3. 

r.  2 
covered  in  bed,  iv.  i.  j.  a, 

Suppl.  i.  ii*  6. 
of  the  brows,  i.  i.  2.  3. 
in  fever  fits,  why,  i.  i .  2-  5. 
from  exercife,  i   i.  a.  3. 
from  heat,  i.  i.  a.  3. 
from  medicines,  i    i.  2.  3. 
Sweaty  hanHs  cured,  i.  3.  ^.  7. 
Swinging,  ii.  i  6  7. 

makes  the  pulfe  flower, 

iv.  2.  i.  10. 
Swing  centrifugal,    Suppl.  i.   15. 

and  3. 

Symbols  of  ideas,  iv.  2.  3.  8. 
Sympathy  direct  and  reverfe,iv.  i. 

i    F. 

•with  others,  iii.  i.  a.  24. 
of  various  parts,  Suppl. 

i.  i».  5- 

reverfe  of  lacleals  and 
lymphatics,  Suppl.  i. 
H    5. 
of  capillaries,  Suppl.  i. 

n.  5. 
direcl:  of  ftoraach  and 

heart,  Sup.  i.  1 1.  5. 
how  to  deftroy,  iv.  a.  a. 

8- 
of  throat  and  pubis,  iv.. 

Syncope,  i.  2.  r.  4 

epileptic,  iii.  2-  i.  15- 
Syngultus,  ii.  i.  i.  6. 

nephriticus,  iv.  i.  i.  7. 
Syphilis,  ii.  1.5.  2. 
Syphilis  imaginaria,  iii.  i.  2.  ^^. 
Syphon  capillary  of  cloth,  ii.  1-3.  i. 

T. 

Taclus  acrior,  i  5.  5. 

imminutus,  1.2.^.  6. 
Taedium  vitae,  ii.  2.  i.  2.  ni.  i,  2- 11. 

iii.  2.  t.  8. 
Taenia,  i.  i.  4.  n. 
Tape-worm,  T.  4.  i.  r. 
Tapping  at  the  navel,  i.  2.  3.  13. 
Tarditas  fenilis,  iv.  ^.  3.  8. 

paralytica,  iv.  2.  3.  7. 
Tarfitis,  ii    1.4  3. 
Taftc.     See  Gufhts. 

bitter,  not  from  bile,  i.  r. 

Tears  fympathetic,  iv.  i,  2.  i,iii.i, 

i.  10 
Teeth,  to  preferve,  i.  i.  4.  5. 

fall  out  whole,  ii   i    4-7- 
Teneimus, 


INDEX  TO  THE  CLASSES.-PART  II. 


Tenefmus,  ii.  i.  i.  n. 

calculofus,  iv.  i.  a.  8. 
Tedium  dolor  nephriticus,  iv.  a.  a. 
n. 

tumor  in  gonnorrhcca,  iv. 

i.  2.  18. 
tumor  in  parotide,  iv.  i. 

i.  19. 
Tetanus  trifmus,  Hi.  i.  i.  13. 

doloriticus,  iii-  i.  i    14. 
Thirft.    See  Sitis  and  Adipfia. 
Thread-worm,  i,  i.  4.  12. 
Throat  fwelled,  i.  a.  3.  20. 

thickens  at  puberty,  iv.  a, 

1.7. 

grown  up,  i.  a.  3.  25. 
Thiufl),  ii  i.  3- 17. 
Tic  doloureux,  i.  a.  4.  12. 
Tickling,  i.  i.  5.  8. 
Timor  orci,  iii.  t-  2.  15. 
lethi,  iii.  i.  2,  14- 
paupertatis,  iii.  i.  2.  13. 
Tinea,  ii   1.5.  n» 
Tinnitus  aurium,  iv.  x.  i.  15. 
Titillatio,  i-  i.  5   8. 
Titubatio  linguae,  iv.  a-  3.  i. 
Tobacco,  fmoke  of  in  piles,  i.  a.  i. 

6. 

Tongue  dry,  i.  1.3.  i.    Suppl.  i.  2. 
coloured  mucus,  i.  i.  3. ». 
Tonfillitis,  ii.  i.  3.  3. 
Tonfils  fwelled  from  bad  teeth,  i. 

2.  3.  21.  ii.  i.  3.  3. 
Tooth-ach,  i.  2.  4.  la.  n.  i.  4,  7. 
Tooth-edge,  iv.  i.  2.  3. 
Toothing,  i.  i.  4.  5. 
Tooth-powder,  i.  i.  4.  5. 
Torpor  of  the  liver,  i.  i.  a.  6, 

of  the  pancreas,  i.  a.  a.  7. 
of  the  lungs,  Suppl.  1.9. 
of  the  flomach,  Suppl.  i.  10. 
of  the  heart,  6uppl.  i.  10- 
Touch.     See  I  actus. 

deceived  three  ways,!,  a. 

5.9.  iv.  2.  i.  10. 
Transfufion  of  blood,  i.  2.  3.  25. 

Suppl.  i.  14-  4- 

Translation  of  matter,  i   3.  2   9. 
of  milk,  i  3   2.  10. 
of  urine,  i.  3.  a.  u. 
Tranfparency  of  cornea,  i.  i.  4.  i. 
of  cryftalline,  i.  a.  a. 

13- 
of  air  before  rain,  i. 

i.  4.  i. 

Tremor  of  old  age.  iii  a.  i.  3. 
of  fever,  iii.  i.  i.  2. 
of  anger,  iv.  3.  i.  4. 
of  fear,  iv.  i    a.  5. 
Tricks  of  the  face,  iii.  i.  1.5.  iv.  i, 

3    2 
Trifmus,  iii.  i.  i,  13. 


Trifmus,  dolorificus,  i.  a.  4.  u. 
Twitching^  of  the  face,  iv.  i.  3.  a. 
Tuilis  ebriorum,  ii.  i.  1.5. 

convulfiva,  ii.  i.  3.  8. 

hepatica,  iy.  2.  x.  8. 

arthritica,  iv.  a.  1.9. 

periodic*,  iy.  3.  4.  a. 

a  pedibus  frigidis,  iv.  a.  I.  7, 
Tympany,  i.  a.  4.  9. 
Typhus,  i.  a.  »•  I.  ii.  i.  3.  |, 

U. 

Ulcers,  healing  of,  i.  1.3.  13. 
of  the  cornea,  i.  1.3.  14. 
from  burns,  i.  1.3.  13. 
fcrofulous,  ii   i.  4.  13, 
of  the  throat,  ii.  i.  3.  3.  H. 

i.  3-  u. 

of  the  legs,  ii.  i.  4. 14. 
Unguium  morfiuncula,  iv.  i.  3.  5. 
Urethra,  fcirrhus  of,  i.  a.  3.  a4- 

riftula  of,  ii.  i.  4.  n. 
Urine,  copious,  coloured,  i.  i.  a.  4. 
copious,  pale,  i.  2.  3.  $. 
diminished,  coloured,!.  1.3, 

diminifhed,  pale,  i.  2.2.5. 
its    mucus,    falts,    Pruifian 

blue,  i.  *.  2.  4. 
why  lefs  and  coloured   in 

dropfies,  i.  i.  3.  7. 
tranflation  of,  i.  3.  a.  n. 
difficulty  of,  iii.  2.  i.  6. 
.  not  fecreted,i.  2.  2.  8. 
pale  after  meals,  iv.  a.  x.  a. 
pale  from  cold  (kin,  iv.  2,  r. 

fediment  in  fevers,  Suppl.  i. 

2.  3. 
pale  in  fevers,  Suppl.  i.  2.3. 

and  5. 

Urticaria,  ii.  i.  3.  16. 
Uteri  defcenfus,  i.  1.4.  8. 
retroverfio,  i.  a.  i.  14. 

V. 

Varix,  i.  2.  i.  19. 
Vacillatio  feniiis,  iii.  2.  i.  2. 
Varicella,  ii.  i.  3.  15. 
Variola,  ii  i.  3.  9. 

eruption  of,  iv-  2.  i.  12. 
Vaforuincapil.  retrogreilio,  i.  3  3.1. 
Venereal  orgafm,  iv.  i.  4.  4. 
difeafe,  ii.  i.  5.  2. 
imaginary,  iii.  i.  2.  ai. 
Ventriculi  aegritudo,  i.  2.  4.  4. 

veficatorio  fan- 
ata,  iv.  i.  i. 

Vermes,  i.  1.4.  10, 
Vertigo  rotatory,  iv.  2.  r.  10, 
of  ('ght,  iv.  a,  i.  r/. 

Vertigo 


524 


INDEX  TO  THE  CLASSES.— PART  II. 


Vertigo  inebriate,  iv.  2.  i.  12. 
of  fever,  iv.  a.  i.  13. 
from  the  brain,  iv.  2.  1. 14» 
©f  the  ears,  iv.  2.  1.15. 
of   the    touch,    tafte    and 

finell,  iv.  2.  i.  16. 
with  vomiting,  iv.  2.  3.  2. 
produces  flow  pulfe,  iv.  *• 

1.  io. 

of  blind  men,  iv-  2.  i.  io. 
life  of  mercurials  in  it,  iv. 

2.  i.  ii. 

Vibices,  i.  2,  i-  16-  Suppl.  i.  2.  7. 
Vigilia,  iii.  i.  2   3.  iv.  i.  3.  6. 
Vinegar  in  petechiae,  i.  2.  r.  17. 

in  fcarlet  fever,  ii.  i.  3.  ii« 
Vifion  acuter,  i.  i.  5.  i. 

diminished,  i.  2.  5.  2. 
expends  much  fenforial  pow- 
er, i.  2.  5.  3. 
Vita  oyi,  iv.  i.  4.  j. 

hiemi-dormientium,  iv.  i.  4- 

2. 

Vitus's  dance,  iv.  2.  3.  2. 
Volition,  three  degrees  of,  iii.  *•  i. 

12. 

leflens  fever,  iii.  2.  i.  12. 

Suppl.  i.  ii.  6. 
produced  fever,  iii.  2. 1. 12. 
without  deliberation,  iii. 

i.  i.  iv. i.  3.  2. 
Vomica,  ii.  i«  6.  3. 
Vomitus,  i.  3.  i.  4. 
Vomendi  conamen  inane,  i.  3.  i.  8. 
Vomiting  (lopped,  iv.  i.  i.  3.  iv.  i. 

i.  F. 

voluntary,  iv.  3.  3-2. 
how  acquired,  iv.  i.  i. 

c.  F. 

vertiginous,  iv.  3.  2.  3. 
from  (tone  in  ureter,  iv. 
3.2.4, 


Wh'i 


Vomiting  from  paralytic  ftroke,  iv, 

3-  2.  5. 
from  tickling  the  throat, 

iv.3.  2.  6. 
fympathifes     with    the 

fkin,  iv.  3.  2.  7. 
in  haemaptoe,  i.  i.  1.4. 
from  defecto^aflbciation, 

iv.  2.  i.  io. 
Vulnerum  cicatrix,  i.  1.3.  13. 

W. 

Watch  f ul  nefs,  iii.  i.  *.  3.  iv.  3.  2.  5. 
Water-qualm,  i.  3.  i.  3. 
Weaknefs,  three  kinds  of,  i.  2.  i. 
Whirling-chair,  Suppl.  i.  15.  3. 
Whirling-bed,  Suppl.  i.  15.  7.  i.  2 

lite  fwelling  of  the  knee,  i.  2.  3. 

ICj. 

Whitlow,  fuperficial,  ii.  i.  4.  5. 

internal,  ii.  i.  2.  19. 
Wine  in  fevers,  ii.  i.3.i.iv.  2.  i.  u. 
Winking,  ii.  i.  1.8.  i.  i.  4,  i.  iv.  3. 

2.  2. 

Winter-fleeping  animals,  iv.  1,4.2- 
Womb,  defcent  of,  i.  i.  4.  8. 

retroverfion  of,  i.  2.  1. 14. 
inflammation  of,  ii,  i.  8. 16, 
Worms,  i.  i.  4.  io. 

mucus  counterfeits,  i.  x, 

.    3-  4- 

in  Iheep,  i.  i.  4.  io. 
Wounds,  healing  of,  i.  i.  $•  13- 

y. 

Yawning,  ii.  i.  i.  9. 
Yaws,  ii.  i.  5.  5. 

Z. 

Zona  ignea,  ii.  i.  5.  9.  iv.  i.  2.  si. 
ii.  x.  a.  14. 


r 


:m. 


n*W 


